Posts tagged ‘medical assessments’

March 23, 2010

Seriously ill ‘forced back to work’

Seriously ill and disabled people are being pushed into finding work without any help or support, a charity has warned.

Citizens Advice said it had “grave concerns” about how sick and disabled people are being assessed for Employment and Support Allowance (ESA).

The allowance was introduced in October 2008 to replace incapacity benefit for new claimants, and to give more support to people who may be able to return to work.

But the charity said that since the allowance was introduced, its advisers across England and Wales had been reporting high numbers of seriously ill and disabled people who were being found “fit to work” under the new work capability assessment.

People who were found to be fit to work included those with advanced stages of Parkinson’s disease and multiple sclerosis, as well as people with severe mental illness, and some who were dealing with acute short-term health problems, such as waiting for open heart surgery. Overall, 69% of people who were assessed for the allowance were refused it.

In its report, which is supported by 18 other organisations, including Macmillan Cancer Support and the Multiple Sclerosis Society, the group warned that the medical test people undergo to assess their fitness to work does not account for the complexities of many illnesses and disabilities.

It said it was also hearing numerous reports of hurried medicals, where vital details were missed and unjustifiable assumptions were made. It added that the assessments did not place enough emphasis on the impact of mental health issues on people’s ability to work.

The charity said that failing the assessment could have an enormously detrimental effect on people. It said people who failed were told they must find work, and they could also be put on jobseeker’s allowance, which it said was a less supportive benefit, while in some cases they may receive no benefits at all.

Citizens Advice also warned that the stress of the test and the prospect of having to fight unfavourable decisions at a tribunal put considerable pressure on people, and risked making it harder for them to return to work.

David Harker, chief executive at Citizens Advice, said: “The current test to determine eligibility for ESA isn’t working. We are seeing cases where the Government’s aim of moving people into work is being totally undermined. Seriously ill and disabled people are being severely let down by the crude approach of the work capability assessment.”

Taken from Yahoo! News UK

March 17, 2010

DWP report finds doubts about work capability assessments among welfare-to-work staff

Jobcentre Plus staff feel many people who pass work capability assessments are not fit for work, according to a study by the Department of Work and Pensions published yesterday.

They believed this was especially damaging for clients with mental health problems and exacerbated their symptoms.

Work capability assessments decide whether people are eligible for one of the two levels of employment support allowance (ESA) or jobseeker’s allowance, which is worth £25 less than the lower level of ESA.

ESA replaced incapacity benefit in October 2008 for new claimants, with the work capability assessment introduced at the same time, and early evidence has shown that more people have been deemed fit to work under the new regime.

Neil Coyle, director of policy at the Disability Alliance, said he sympathised with jobcentre staff’s frustration. In his experience, many were unable to deliver support they felt clients needed because the assessment made them ineligible for ESA.

The study also confirmed a large backlog of appeals against work capability assessment decisions.

Coyle said the backlog was likely to get worse because the government intends to push all remaining incapacity benefit claimants through work capability assessments. “It’s worrying, not least for those of us who foot the bill because appeals are very expensive,” Coyle said.

The study, based on in-depth interviews with more than 70 staff and customers, found considerable delays in having a work capability assessment and this limited the scope of work-focused interviews. These take place between nine and 13 weeks after a client has made an ESA claim and are aimed at supporting claimants into work.

Some people had received no assessment by the time of their third interview.

Benefit delivery centre staff, who process claims, reported that there was an incentive in the system for appeals because it allowed claimants to continue claiming ESA, as opposed to jobseeker’s allowance, until the appeal was heard. Several staff were acutely concerned about the extra costs this entailed.

Minister for disabled people Jonathan Shaw said: “This research was carried out some time ago soon after the benefit was introduced and we have made considerable improvements since then. We continue to see where improvements and changes are needed to ensure that ESA is working as it should be.”

A Department for Work and Pensions spokesperson said the work capability assessment was currently being reviewed to ensure that it was accurately identifying people for the most appropriate benefit and work was underway to streamline the appeals process.

Taken from CommunityCare

February 9, 2010

Disability tests in need of overhaul

The Work Capability Assessment (WCA), which came into operation nearly a year and half ago, is the test that is meant to determine whether people are eligible to receive the new employment and support allowance, which offers support for disabled people and people with long-term conditions to get in to work. But as more figures become available showing just how tough this new test is, and as more claimants report bad experiences, have we reached the point where we need to ask whether the test itself is actually fit for work?

The early indications for the test were not positive. While to its credit, the Department for Work and Pensions did engage a large number of disability organisations in the design process, many of the organisations (including Leonard Cheshire Disability) felt that their concerns were not always listened to, and that changes were being made without enough real evidence. It was clear from the outset that the new test was being made tougher, even though the old test had been described by a former secretary of state as “the most stringent” in the world. The result, of course, is that there are far fewer people being assessed as needing additional support to get back to work, and fewer people receiving the additional financial support that the employment and support allowance can provide.

The government contracts out the responsibility for carrying out these tests to a company called Atos, which in turns employ “health professionals” to conduct the assessments. But there have been serious concerns both about whether the people conducting the tests have sufficient expertise to fully understand the huge range of different impairments that they might encounter, and whether the test itself is appropriately constructed. Already research has highlighted problems: the National Autistic Society found that the system was not always working for people with autism; Citizens Advice Scotland reported that the system was causing disabled people “unnecessary financial distress and emotional strain”; Macmillan and Citizens Advice reported that some people with terminal cancer were not being fast-tracked through the system.

Those who feel that they have not been properly assessed can complain directly to Atos. But very often a poor assessment will lead to an appeal, a tribunal and delays, as well as extra expense to both the individual and the taxpayer. Most importantly, of course, every time the test doesn’t work appropriately it can mean someone missing out on the support that they need to find work, and the financial support that they need because of their impairment.

Given all the concerns with the system it might seem positive that a review of the WCA has been ongoing for some months. But sadly the review was not set up in response to the serious difficulties that some disabled people were experiencing with the system. It was set up to make changes to the assessment that the government estimates will mean 10% fewer people again receiving the employment and support allowance.

Benefits should not be about targets but about ensuring the right support is delivered to those who need it. If disabled people can be supported into work then there will be a direct benefit for them, and also for the taxpayer. But if people are forced off the benefits designed to support them and into appeals by an unfair system, then that could lead to wasted opportunities, and even poverty. While the employment rate for disabled people is just below 50%, an overwhelming number do want to work. The employment and support allowance should be seen as the opportunity to deliver the support that many disabled people need to move into employment.

It is not too late to widen the current review of the WCA so that it really examines what needs to happen to make sure that the benefits system meets the needs of disabled people. An assessment that just gets tighter and tighter, restricting support for more and more people, will simply not be fit for purpose.

Taken from guardian.co.uk

January 19, 2010

Seriously ill patients ‘told to work’

A BBC investigation has heard claims of seriously ill patients being told they are fit enough to work and denied benefit payments.

Two former doctors for the private healthcare company Atos, which carries out the medical assessments have expressed concerns that the checks are being done too quickly and that the system is biased towards declaring people fit for work.

BBC Scotland’s Social Affairs Reporter, Fiona Walker, has been investigating why some of those who had high hopes for ESA say it has been a failure

Man in a wheelchair

Employment Support Allowance, or ESA, is replacing Incapacity Benefit. It’s supposed to support the very sick, and as people get better, help them get back into the workplace.

The government said it wanted to get a million people back to work by 2015 but more that one year after introducing ESA, it says it can’t measure how many people the scheme has got back into the workplace.

During the investigation, we’ve heard claims that terminally ill patients are being told to attend back-to-work interviews while they apply for the new benefit.

We also heard concerns that the medicals are declaring seriously ill people as fit enough to go to work.

One of the patients we spoke to was Maureen Leitch. She says she was called in for a medical assessment just a few weeks after undergoing chemotherapy and radiotherapy for vulval cancer.

She was declared fit for work and told she wasn’t entitled to ESA.

She said: “I was struggling terribly with the whole cancer. I was in extreme pain… It was a whole load of hassle, and aggravation that I didn’t need at the time I was going through the journey of the cancer… I feel insulted and badly let down, with the system.”

Maureen appealed the decision and it was overturned, meaning she was eventually awarded the benefit.

Currently, there are 44, 000 people waiting for their appeals to be heard. More than a third of people are winning their appeals.

Charities and organisations including Citizens’ Advice Bureau, say they’re worried that thousands of pounds of taxpayers’ money is being wasted because of the number of people going to appeal.

Everyone we’ve interviewed for this investigation agrees that getting people back to work can be good for them.

Frequent appraisals

What they’re concerned about is the way the system is working in practice.

Dr Chris Johnstone is a GP in Paisley. His work to help his patients back to work helped shape the ESA policy.

He said: “I have no problem with a rigorous medical assessment done in a supportive fashion.

“But I think if you have a slipshod one done, as it appears to be anecdotally, that’s unfair for the people going through the system. It feels like some of it is done inappropriately and it’s almost being done to save money rather than to look after people.”

Job centre

Ultimately the decision on whether you get benefit or not is down to the Department of Work and Pensions (DWP), but they have contracted a private healthcare company called Atos to carry out the initial medical assessments.

I’ve spoken to two doctors who used to work for Atos. They say they are concerned about the way checks are being done. They both say they are worried that speaking out will affect their medical careers so we’ve agreed not to reveal their names.

This is what one of the doctors told me: “We would frequently have appraisals. They were all about how many clients you had seen and the average length of time it took to complete each assessment and write the reports.

“I wanted to know if they were happy with the quality of the reports I’d done but they hadn’t even looked at my reports, only at the time it had taken. It’s really tough to qualify for ESA.

“When doctors go in for the day’s assessments, they pretty much know the clients are going to be turned down.”

The other doctor I spoke to backed up those claims.

We asked to do an interview with Atos, but they refused.

Gaining skills

Instead they gave us a statement saying: “We are continually monitored and audited by the government to ensure that it completes the highest standard of assessment and that medical advice is correct.

“Atos Healthcare and its employees are not advised of the result of the assessment and the outcome has no bearing on Atos Healthcare targets or remuneration.”

Helping people back to work is one of the key aims of ESA. But the government can’t tell us how many people this new scheme has got back into work.

The minister for Disabled People at Westminster is Jonathan Shaw, MP. I asked him why his department couldn’t tell us how many people ESA had successfully got back to work.

He said: “What’s essential is that we are providing a programme, across the board, not just for ESA claimants but for youngsters, for disabled people for elderly people, to try and gain the skills that they can to stay in the labour market and return to work.

“We’ve got the pathways to work programme, which as I say is helping thousands of people who I’ve met up and down the country… this is early days, for the Employment Support Allowance.”

Mr Shaw also said he would be looking into the way cancer patients are treated.

Taken from BBC News