Adult Disability Payment: Consultation on the Mobility Component

Background

In 2015, it was agreed that the Scottish Parliament should have some powers over disability benefits. These powers are set out in the Scotland Act 2016^[5]. Using these powers, we created support for disabled children and young people in the form of Child Disability Payment. Then we launched our replacement for PIP in Scotland in the form of Adult Disability Payment.

Adult Disability Payment is the most complex payment delivered so far by Social Security Scotland. It is linked to other forms of support which remain reserved to the UK Government, meaning that significant changes to Adult Disability Payment may impact upon existing arrangements for disabled people to access these other forms of financial support. It also involves a much more complex decision-making process than most of the other payments we have delivered so far.

Our disability benefits are easier to access and have been designed with disabled people. We are committed to ensuring that people receive the support that they are entitled to, by reducing stigma and seeking to positively encourage take-up of all our social security payments. Social security is an investment in the people of Scotland, with Adult Disability Payment providing important financial support to disabled people.

Exploring the evidence

The Scottish Government has undertaken an extensive and comprehensive period of evidence-gathering during the development of Adult Disability Payment.

• In 2016, our Consultation on Social Security^[6] asked for views from the public on the overall approach to Scottish disability assistance, as well as inviting comments on ideas for change.
• The Ill Health and Disability Benefits Stakeholder Group was set up in March 2016 to inform and influence the development of policy options relating to disability benefits.
• In April 2017, we established the Disability and Carer Benefits Expert Advisory Group^[7], to provide independent advice on the development of our disability benefits. To date, the Group’s advice has included recommendations on the development of Adult Disability Payment, decision-making, consultations, award duration, and PIP case law.
• We have worked with our unique Experience Panels^[8], which were set up in 2017 and include people with lived experience of the UK benefits system, in the development and design of disability benefits.
• In March 2019, we launched the Consultation on Disability Assistance^[9] to inform more detailed proposals on disability assistance, including Adult Disability Payment. The consultation received 263 responses from a range of stakeholder organisations and people, with most responses being broadly supportive of our proposals.
• In December 2020, we consulted on the draft regulations for Adult Disability Payment^[10], seeking views on the proposed eligibility criteria and to identify any gaps, issues, or unintended consequences.
• The Scottish Commission on Social Security scrutinised the draft regulations for Adult Disability Payment and published its report in October 2021, making 24 recommendations and two observations on the draft regulations.

Given that Adult Disability Payment is a new payment, some of the evidence we have considered relates to PIP. This is because the eligibility criteria for both payments are broadly similar, but the way in which they are delivered is significantly different.

Differences between PIP and Adult Disability Payment

Social security is a human right and none of us know when we might need it – it is a shared investment to help build a fairer society, together. We are developing a system that is rooted in trust to make sure people can access the support that they are entitled to.

We made several changes to apply the eligibility criteria fairly and consistently. We want to ensure that the impact of a disability or health condition on a person, including the impact of fluctuating conditions, is fully considered.

We are ensuring that accessing Adult Disability Payment is as straightforward as possible and we always start from a position of trust. We are making sure that people can access the disability assistance they are entitled to. A person can apply for Adult Disability Payment in a way that suits them best: online, by post, over the phone or face-to-face.

When making a decision, Social Security Scotland usually only needs to collect one piece of supporting information from a professional, such as a social care assessment, medical report or prescription list. Also, we equally consider all sources of information, including from a person’s family, carers and friends. Social Security Scotland can collect information on a person’s behalf if they do not have the information required to hand.

Social Security Scotland fast-track applications from people with a terminal illness. Clinicians use their judgement to determine whether a person is terminally ill, rather than being based on a fixed period of life expectancy.

There are no UK Government-style assessments and Social Security Scotland never use the private sector to carry out health assessments. People are only invited to a consultation on occasions when Social Security Scotland require more information so that they can make a decision. On occasions when a consultation is required, a person experiences a compassionate conversation with a health and social care professional who starts from a position of trust. There aren’t any degrading functional examinations, such as asking a person to “touch their toes”.

Social Security Scotland work to get decisions right first time, reducing the need for people to go through a re-determination or appeal. However, when people believe that Social Security Scotland have not made the right decision then there are of course opportunities to challenge decisions.

We are funding an independent advocacy service which is available to support people across the full application process, including re-determinations and appeals.

Moreover, following the transfer of a case from the UK Government to Social Security Scotland, which includes a case review in due course, people can access Short-term Assistance while they are challenging a decision after a review. This provides people with the same amount of money they were getting before a decision was made to lower or stop their payment. Short-term Assistance does not need to be repaid either.

We have made changes to the review process. Reviews are light-touch and will take place less frequently than in the UK Government system. Importantly, we have introduced indefinite awards for some severely disabled people whose needs are highly unlikely to change. This helps to avoid the stress and anxiety that can be associated with reviews, while providing long-term financial security to people. Indefinite awards support people to lead their lives more independently and fully.

The table below provides a summary of the key improvements we have already introduced as part of the delivery of Adult Disability Payment:

Table 1 Differences between PIP and Adult Disability Payment

PIP (UK Government)

Limited advice is available on disability benefits. There is no take-up strategy.

Adult Disability Payment (Scottish Government)

We have telephone, online and Local Delivery services to advise on what payments are available and explain clearly how people can go about applying for these.

We have a benefit take-up strategy to encourage people to take up the payments that they are entitled to.

We are funding an independent advocacy service which is available to support people across the full application process, including with re-determinations and appeals.

PIP (UK Government)

No way of applying for disability benefits online.

Adult Disability Payment (Scottish Government)

New applicants can apply for Adult Disability Payment in a way that suits them best – online, by post, over the phone or face-to-face.

PIP (UK Government)

People do not receive updates on how their case is progressing.

Adult Disability Payment (Scottish Government)

We keep people updated on the progress of their case.

PIP (UK Government)

The lack of supporting information can significantly affect the outcome of an application.

Adult Disability Payment (Scottish Government)

Social Security Scotland only needs to collect one piece of supporting information from a professional, such as a social care assessment, medical report or prescription list, when making a decision. We place equal consideration on all sources of information, including from a person’s family, carers and friends.

PIP (UK Government)

Outcome letters provide limited information about the decision that has been made.

Adult Disability Payment (Scottish Government)

With every notice of determination, we provide detailed reasons to the person about how we reached our decision.

PIP (UK Government)

No financial support when challenging a decision.

Adult Disability Payment (Scottish Government)

People are able to access Short-term Assistance while they are challenging a decision after a review. This provides people with the same amount of money they were getting before a decision was made to lower or stop their payment.

PIP (UK Government)

Award reviews even for severely disabled people with needs unlikely to change.

Adult Disability Payment (Scottish Government)

We have made changes to the review process. These are light-touch and will take place less frequently than in the UK Government system. Importantly we have introduced Indefinite Awards for severely disabled people with needs which are highly unlikely to change.

PIP (UK Government)

People applying for PIP are routinely required to attend a private sector face-to-face assessment.

Adult Disability Payment (Scottish Government)

There are no UK Government-style assessments and Social Security Scotland never use the private sector to carry out health assessments. People are only invited to a consultation on occasions when Social Security Scotland require more information so that they can make a decision. On occasions when people are invited to a consultation, they experience a compassionate conversation with a health and social care professional who starts from a position of trust. There aren’t any degrading functional examinations, such as asking a person to “touch their toes”.

PIP (UK Government)

Assessments do not take place at a time and location that suits the person.

Adult Disability Payment (Scottish Government)

Consultations take place through a range of channels.

These changes do not represent the limit of our aspirations for disability assistance. We know that some people would like us to go further in particular areas, including the considerable interest in the way in which the criteria for the mobility component is applied.

About the eligibility criteria for Adult Disability Payment

Adult Disability Payment is made up of two parts, called components: a daily living component and a mobility component.

A person may qualify for one or both components. The amount a person may be entitled to depends on how their disability or condition affects their ability to do everyday activities and get around. For both components, a Social Security Scotland case manager looks at a person’s ability to complete several different activities.

There are 10 activities for the daily living component:

• Preparing food
• Taking nutrition
• Managing therapy and monitoring a health condition
• Washing and bathing
• Managing toilet needs or incontinence
• Dressing and undressing
• Communicating verbally
• Reading and understanding signs, symbols and words
• Engaging socially with other people face to face
• Making budgeting decisions

There are also two activities for the mobility component:

• Planning and following journeys
• Moving around

For each activity, there are several statements (called descriptors) that may apply to the person. For example, for the “moving around” activity the descriptors are:

a. Can stand and then move more than 200 metres, either aided or unaided.

Points 0

b. Can stand and then move more than 50 metres but no more than 200 metres, either aided or unaided.

Points 4

c. Can stand and then move unaided more than 20 metres but no more than 50 metres either aided or unaided.

Points 8

d. Can stand and then move using an aid or appliance more than 20 metres but no more than 50 metres, either aided or unaided.

Points 10

e. Can stand and then move more than 1 metre but no more than 20 metres, either aided or unaided.

Points 12

f. Cannot, either aided or unaided, —

(i) stand, or

(ii) move more than 1 metre.

Points 12

A case manager in Social Security Scotland selects the most appropriate statement that applies to the person for each activity. The statement that is selected depends on several factors, such as whether their condition fluctuates, but only one statement can be chosen.

Case managers must consider the reliability criteria when assessing whether the person can carry out the activity^[11]. This includes the person’s ability to carry out an activity:

• safely,
• to an acceptable standard,
• repeatedly, and
• within a reasonable time period.

Case managers also consider a person’s ability to carry out an activity using an aid or appliance that they:

• normally use, or
• could reasonably be expected to use.

The rate a person is paid depends on how many points they score for either component. If the person scores:

• between 8 and 11 points they are entitled to the standard rate, or
• more than 12 points, they are entitled to the enhanced rate.