Disability benefits evaluation - case transfer: qualitative research - annex A

4. Review process

This chapter focuses on clients’ experiences of the review process after case transfer. It draws on evidence from discussions with clients previously in receipt of PIP and DLA who have been through a review following their transfer and staff who have worked on case transfer reviews. The findings are presented in chronological order to reflect clients’ experiences as they went through the process. They are also presented in relation to the relevant short- and medium-term outcomes in the logic model; these are highlighted throughout the chapter where relevant.

Key findings:

• Clients reported that their payment was continuous during the review process.
• Clients were reassured and relieved that they would not have to undergo a face-to-face assessment.
• Clients’ experiences of the review process varied depending on the circumstances of their transfer from the DWP (e.g. those reporting a change of circumstances found the forms more tiresome to complete than those who were due a review).
• Those who received an outcome that met or exceeded their expectations felt the decision was right and that their case had been considered fairly.
• Those who did not receive the outcome they had hoped for felt disappointed. While some acknowledged that the decision was nonetheless fair, others felt that their circumstances had not been fully considered.
• Clients described the review process as easier than they thought it would be, with Social Security Scotland staff widely viewed as helpful, friendly and reassuring.
• However, clients still felt worried about the process and the outcome.
• Where there were issues (e.g. lack of clarity around timescales, uncertainty over backdating payments, communication errors or knock-on impacts on other benefits) this exacerbated feelings of stress and anxiety.

Initial contact about the review

The intended outcomes most relevant to this stage in the process include:

• Individuals understand what happens next.
• Individuals know who to contact for help and support.
• Individuals do not feel undue stress/anxiety about the review element of the process.

Understanding what happens next

Clients typically reported hearing about the review by letter, which they received around the time that the transfer of their case was complete. Their understanding of what the review would involve once they received the initial letter was mixed. In general, clients felt that the letter contained plenty of information and clearly explained what would happen next. However, this was not a universal view; in other cases clients felt the review process was not explained clearly. Some clients relied on someone else to help them understand the information, such as a carer or welfare rights officer.

“It went through the whole thing saying the review is coming up, what is a review, it tells you how a review works, and what affects other benefits, so there was plenty information on what was going to happen.” (PIP client)

“I wasn’t sure what it would involve […] Social Security Scotland didn’t explain things very well.” (DLA client)

Staff also noted that the initial letters sent to clients could cause confusion. For instance, they described how clients undergoing a scheduled review (having transferred because they were due a review, see appendix 1 for a definition) would be sent a declaration form and a change of circumstances form. Due to not understanding which form they should complete, some clients would complete both; declaring no change on one form, while also reporting small changes on another. This caused delays while staff processed the slightly conflicting information provided. This was described as a fairly common occurrence.

Such misunderstandings were exacerbated in cases where clients said that they had been sent the wrong forms initially. Among clients interviewed for this research, this affected those transferring from DLA to ADP who said they had submitted the forms sent to them, but were subsequently told that they should have instead completed a change of circumstances form (in one case) or a transfer review form (in another case). These communication issues are explored further in the communication section of this chapter.

A general view among staff was that the initial letter from Social Security Scotland about the review is lengthy and confusing to clients, prompting them to contact them for clarity.

“Clients receive extensive communication, but it can be overwhelming for them so it’s not always clear or fully read.” (Staff)

Knowing who to contact for help and support

Clients did not have much recollection of who to contact for help and support, although they assumed that the letter would have contained some guidance on this. However, it should be noted that for some clients it was difficult to recall details of what the initial communications contained, given the time that had passed between them first hearing about the review and being interviewed for this research.

As mentioned above, some clients relied on existing support networks (such as carers or welfare support officers) for help. However, others noted the offer from Social Security Scotland to have local delivery staff visit their homes to help them complete the forms. Clients who took up this offer spoke very positively about it and were appreciative of the support, indicating that they would have otherwise struggled to complete the forms.

“There is no way I would have been able to tackle that booklet on my own.” (DLA client)

How clients felt about the review element of the process

Some clients described feeling worried when they received communication about the review, which was underpinned by a general concern that any review held the possibility of a payment being stopped. However, there was also a sense of hope that the review experience would be better with Social Security Scotland than it had been with the DWP.

“[I felt] okay I suppose, obviously a little anxious because with the DWP they were very un-trusting so it always felt like it was an uphill battle. I know [Social Security Scotland] had said it would be done with more fairness and things like that but it was still kind of in the back of your head, ‘oh what if I lose this’.” (PIP client)

Clients generally viewed Social Security Scotland more favourably than the DWP, noting their stated commitment to dignity, fairness and respect in the letters. They were also reassured that their payments would be continuous throughout the review process, which they picked up from the letter or after getting in touch with Social Security Scotland to check details about their review. This would otherwise have been a source of anxiety for them.

“I was reassured from [Social Security Scotland], that I wouldn’t lose any payments while this was all [happening] …They just went through everything that I got and they told me basically you will not lose payments, we will get this reviewed and we will get it sorted ASAP, and I just felt at ease then.” (PIP client)

Clients who were transferring from DLA to ADP tended to express greater uncertainty about the review process and what to expect, as many had been on indefinite awards and had not had a review for a long time (or ever). Related to this, there was a sense of surprise and apprehension about the size of the change of circumstances form; one client described feeling “gobsmacked” by the length of it.

“When I got the form, I was a bit apprehensive about it as it was so thick. And I wasn’t sure what was relevant.” (DLA client)

Going through the review process

The intended outcomes most relevant to this stage in the process include:

• Individuals have a positive experience of the review process.
• Clients know what is happening and when.

Experiences of the review process

Clients’ experiences of going through the review varied depending on the circumstances of their transfer from the DWP (i.e. whether they transferred because they were due a review or because they reported a change of circumstance).

Completing the forms

Clients who had transferred because they were due a review appreciated the fact that Social Security Scotland had a good deal of information about their award already, meaning they only had to confirm that the information was correct or notify them of any changes. While this was viewed as a positive aspect of the review by clients, staff identified this as a key factor in the time it takes to process case transfer reviews. Reviews for PIP clients were felt to take longer than DLA reviews, due to the time needed to process existing information attached to the case file that had been transferred over from the DWP. However, PIP clients did not raise the processing time as an issue from their perspective.

“I ticked the boxes saying nothing had changed […] I thought there might have been a phone call. [It was] obviously a lot easier than the first [review with the DWP].” (PIP client)

“The review of information is really hefty work.” (Staff)

Clients whose case had transferred because they reported a change of circumstances had a different perspective on the form they received, which was commonly described as “lengthy”, “stressful” and “tiresome” to complete. One client felt that the same questions were being asked in different ways to try and catch them out or “trick” them in order to stop the payment. This worry was based on past experiences with the DWP where they had been scared to say the “wrong thing”.

For those with conditions that affect their mobility, a particular challenge was getting copies of medical records as they would have to travel to their GP surgery to collect them. It was also mentioned that an online option for the form would have made the process more accessible for those with certain disabilities who find writing by hand difficult.

“The form is very clear, easy to read, and there is plenty of room for writing things in. But I found the lack of an online version quite a problem for me with my particular disability.” (DLA client)

Timescales

As highlighted above, among PIP clients (including those who were due a scheduled review and those who had reported a change of circumstances) the timescales for the review appeared to be either in line with expectations or quicker than expected.

“I was very surprised at how short it was, then I didn’t think too much about it. (PIP client)

DLA clients who had reported a change of circumstances viewed the timescales differently. Rather than starting from the time they were first contacted about a review, they saw the review process as starting from the time they first notified the DWP of the change and ending with the outcome given by Social Security Scotland. The timescales for this ranged from six months to a year for some clients and, as such, were viewed more negatively. The wait caused these clients to feel anxious and stressed; for one client who was awaiting an outcome at the time of interview, the wait was so difficult that they had considered withdrawing their case altogether.

Client: “I don’t [have confidence in the process] because I’ve spoken to other autistic people who have said it’s been over a year, and they have not heard anything.”

Client’s Carer: “She’s come very close to saying she can’t cope with it and just withdrawing.” (DLA client, interviewed with carer)

PIP clients who had reported a change in circumstances seemed less concerned about the overall time taken to process the transfer and review. Their relief about the review process being so much easier than they had expected (based on their experiences or expectations of a DWP review) may have overcome concerns about the waiting time that they might otherwise have had.

Timescale issues were echoed in discussions with staff; they highlighted the backlog of cases as a challenge which was causing them frustration as well as clients. The time needed to work through the backlog was affected by the need, in some cases, to collect supporting information from professionals. Staff reported seeing an increase in the number of unscheduled review calls from clients seeking an update on their case (see Appendix 1 for a definition of unscheduled review). They perceived this to be a result of clients not distinguishing between the case transfer and review elements of the process.

“[Clients] are not fully aware of the process and just see it as ‘well I started transferring in November and it’s now May’. They don’t see transfer and review as two separate entities.” (Staff)

Where clients had a Motability lease or other benefits/support to manage, the wait for their review to be completed caused further frustration and worry as they experienced knock-on impacts to these other benefits. Clients mentioned delays in getting access to cars, bus passes and housing benefit while they waited for an outcome of their review. One client, whose Motability lease renewal was overdue, described being constantly contacted by the garage to resolve the issue which caused ongoing stress.

“[It] was really frustrating as I just needed to phone the garage. It was really stressful [as] the car is a massive part of my life”. (PIP client)

Staff had experience of this too, noting that Social Security Scotland transfer letters were not being accepted by Local Authorities or Motability providers as evidence of someone being in receipt of disability benefits. In some of these cases, staff said they would bring reviews forward to prevent clients from missing out on other support. However, as outlined above, evidence from client interviews suggests that in other cases clients experienced delays or missed out on other support.

Communication with Social Security Scotland

Clients typically reported having at least some direct communication with Social Security Scotland during the review process, either due to the client contacting them for an update or clarification on their case, or (less commonly mentioned) due to Social Security Scotland contacting them for more information.

The most common reasons that clients cited for getting in touch with Social Security Scotland were to find out what was happening with their case or to seek clarity on the review process (for example, to check whether or not there would be a face-to-face assessment). The perspective of staff was that clients do not understand the review process and so they receive a lot of ad hoc queries as a result of that. This was not felt to be limited to a particular client group. Social Security Scotland staff were consistently described as “friendly”, “helpful”, “polite” and “easy to deal with”. Clients also highlighted the reassurance they felt after querying their case with staff.

“When I received the [review] letter, I called [Social Security Scotland] up, and I asked them about it, and they were saying, ‘right, it is nothing to worry about, we are going to do this, we are going to do that. We will go through your claim [sic] and we will look at everything that is on it [and] if anything needs added’, she goes, ‘but you will not be left out’, as in there is nothing that they are going to be doing that I will not know about. So, that was a relief.” (PIP client)

In one case, a client recalled Social Security Staff not being able to resolve their query immediately but calling back at an agreed time. This was reassuring to the client and made them feel that staff were reliable, even if they were not able to answer their query right away.

“The man said he’d call me back and he did. Gave a date and time and did call back then. I found that really helpful – at least I knew that I would be contacted and knew that my benefit wasn’t going to get messed up.” (PIP client)

A more exceptional experience with Social Security Scotland was described by a client who had several interactions with staff over the course of their review. They felt that information was not being recorded during these interactions as they were having to repeat the same things on different calls. As a result, the client did not feel listened to by Social Security Scotland.

While clients generally reported positive interactions with Social Security Scotland staff, some broader communication issues were highlighted. As mentioned above, where clients received the wrong forms from Social Security Scotland initially this caused some confusion which was further exacerbated when staff did not know which form they should complete or when they provided contradictory answers. Clients also said they felt worried when they subsequently received letters saying that their payment was going to stop due to their forms not being submitted. These letters were sent despite Social Security Scotland being aware that clients had received the wrong forms or had not been able to submit their forms yet (e.g. because they were waiting for an appointment with local delivery staff).

“I got a letter saying ‘suspending payments’ in bold which was a bit scary and I was a bit cross about it.” (DLA client)

Clients who had experienced this contacted Social Security Scotland to check what was happening. While they reported that staff were helpful and reassured them that they could ignore the letters which had been sent automatically in error, it nevertheless caused additional stress and worry; prompting one client to wonder whether payments could be automatically stopped in error too.

“[My Aunt] was sitting in her wee house worrying [about her payment being suspended] and it’s not fair.” (DLA client, interviewed with carer)

Another issue raised was a lack of communication from Social Security Scotland on the progress of reviews, which made clients feel like they had to chase for updates or wait anxiously. In the absence of updates, clients commonly reported ongoing stress, frustration and worry. These feelings were heightened among those who experienced difficulties with Motability or other benefits while awaiting an outcome (as highlighted above), which impacted negatively on their view of Social Security Scotland.

Staff also felt there was a general lack of updates from Social Security Scotland during the review process, which they perceived to be causing clients stress and anxiety.

“[Clients] do get stressed and anxious about the transfer process because of the lack of communication.” (Staff)

Consultations

Clients were asked if they had had a consultation as part of their review. These would involve a pre-scheduled discussion with a practitioner from Social Security Scotland about their needs.

Most clients interviewed said they had not had a consultation as part of their review. On the prospect of having one, feelings were mixed; one view was that it would not be anything to worry about, while another was that it might cause added stress.

“[Having a consultation] would have stressed me out more I think because everything I was going through anyway just the thought and just having to like having to explain yourself over and over and over again.” (DLA client)

A client who did have a consultation indicated that it was not a long conversation, and that the person they spoke to was “nice”. She felt that she was “given the opportunity to say things” and “didn’t feel hassled”.

Knowing what is happening and when

For those not reporting a change of circumstances, the review process was generally considered to be clear. Clients transferring from PIP to ADP were, in general, more likely to view the process positively, describing it as “easy”, “uncomplicated” and “streamlined”. One PIP client, upon realising that the review would be conducted by Social Security Scotland rather than the DWP, stated that they expected a more “streamlined [and] respectful process”.

However, even among those who felt the process was straightforward, there were comments about a lack of clarity around timescales. Clients said they felt uncertain about how long it would take to receive an outcome after completing the forms, which in turn contributed to anxiety about the outcome.

“Not knowing how long it would take [there was] just that little bit of anxiety that I might not fit their criteria.” (PIP client)

Staff agreed that there was a lack of clarity for clients around the timescales for reviews. In their view, clients who had reported a change of circumstances expected their cases to be dealt with straight away. They thought that these expectations were not effectively managed due to a lack of understanding among staff about how long the case transfer and review elements might take.

“These clients are waiting quite a length of time, and I don’t think the communication is particularly clear to them, and I think when they are getting on the phone to us, Client Advisors are not clear on the case transfer either. That’s not good because [clients] are getting different answers, and that is making them more upset and can make them stressed, and we are obviously trying to avoid [that].” (Staff)

In particular, clients were unclear about the backdating of payments where a change of circumstances had been reported to the DWP. Some said they had waited between six months to a year since first reporting the change, so they felt it was unfair that the payments were not backdated to when they had initially contacted the DWP about the change.

“Because I’ve transferred over to the Scottish Adult [ADP], they can only backdate my money that I’m due [from] the start of my review, which I found quite unfair. I have been waiting for this to take place and I have waited and I’ve waited and I’ve waited.” (DLA client)

Staff also highlighted that the backdating of payments was a common client query and one which they did not feel adequately equipped to answer due to it being a difficult thing to explain and due to a lack of guidance around it.

“[Clients] think it will go back to the date when they reported their change to the DWP and aren’t aware of this kind of eligibility checking.^[5] Letters are sent to them, but it is obviously not very clear, so we are getting a lot of phone calls and complaints about that, because the client is expecting backdated payments from then.” (Staff)

“It is quite a hard thing for us to explain, and I think the staff struggle with it as well.” (Staff)

Receiving the outcome

The intended outcomes relevant to this stage in the process include:

• Individuals feel that decision-making is fair and transparent.
• The right decision is made first time by Social Security Scotland.
• Individuals feel treated with dignity, fairness and respect by Social Security Scotland.

Fair, transparent, and correct decision-making

Clients’ views on the outcome were primarily determined by whether or not the decision met or exceeded their expectations. It should be noted that no clients interviewed for this research reported receiving a reduction or loss of award following their review.

Where nothing changed with a clients’ award (and they were expecting this) or where an award was increased, feelings about the outcome were generally positive. There was a broad perception that Social Security Scotland had considered their needs, conducted the review fairly and made the right decision first time.

“It made me reassured and not doubting what’s happening. I have 100% confidence in Social Security Scotland to make the right decision. As soon as I told them, they took it all on board. Nothing was left out and it happened quickly.” (PIP client)

There was also a clear sense of relief among this group, who felt able to move on with their lives, secure in the knowledge that their payments would continue and that their situation had been “recognised” by Social Security Scotland. One client said the outcome had boosted their spirits and enabled them to move forward with their plans, as the process had not taken as much energy as they thought it might have.

“It actually spurred me on to apply for University […] that I would say is thanks to the review actually [and] me having enough energy, because I wasn’t put through a meat grinder over the course of the process.” (PIP client)

Where nothing changed with an award but they had hoped for an increase, clients expressed feelings of disappointment. They were less likely to feel that Social Security Scotland had considered their circumstances or that the decision was fair. Where other forms of support or communication about other benefits had been impacted during the review process, this added further to their sense of frustration.

“I need more help now. I put down everything on the form but I felt like they didn’t care.” (DLA client)

In one case, a client did not feel that the right decision had made or that Social Security Scotland had considered their circumstances fairly. They said that the outcome letter did not reflect what they had told staff during the review about the changes in their condition. They planned to appeal the decision.

Those who had submitted their review forms but had not yet received an outcome reported a mix of feelings, including worry that their award might be reduced or taken away but also hope that Social Security Scotland would consider their needs and take decisions appropriately. This hope was grounded in their positive interactions with staff throughout the review process.

However, problems arising during the review processes tended to reduce the level of trust clients had in Social Security Scotland to make the right decision. These issues, as highlighted above, included:

• A lack of clarity around timescales for the review.
• Uncertainty over whether the payment would be backdated.
• Communication errors (e.g. having been sent the wrong form initially).
• Other benefit payments/support being held up while awaiting an outcome.

Dignity, fairness and respect

As outlined earlier, clients noted Social Security Scotland’s stated commitment to the principles of dignity, fairness and respect. Although they identified some issues with the review process, discussed above, they did feel that they had been treated better than they had been previously by the DWP.

PIP clients considered the process to be easier and more coordinated than they had expected it be, given negative perceptions or experiences of the DWP reviews.

“I was always nervous because the DWP just has a very bad reputation for handling people’s claims [sic] and how they treat people, and I haven’t received it personally, but I have felt different about Social Security Scotland, because I definitely felt a greater sense, I suppose, of respect and fairness about it.” (PIP client)

In particular, there was a strong sense of relief among clients that face-to-face assessments would not be required. This was an aspect of the DWP reviews that they described as “harrowing” and “daunting”.

Overall, there was a perception among PIP and DLA clients that Social Security Scotland is an easier agency to deal with than the DWP and that they take a more person-centred approach.

“I feel that someone’s looking after me.” (DLA client)

Policy commitments in relation to the review process

This chapter concludes with a summary of clients’ experiences of the review process in relation to the policy commitments outlined in the logic model.

Policy commitment: Correct payment made at the correct time

Summary of client experiences in relation to reviews: No clients said that their payment was disrupted during the review process.

Policy commitment: No face-to-face DWP reassessments

Summary of client experiences in relation to reviews: Clients were reassured and relieved that this would not be required as part of reviews with Social Security Scotland. No-one reported having a face-to-face DWP reassessment since the start of their case transfer.

Policy commitment: Clear communications with individuals

Summary of client experiences in relation to reviews: There were mixed views about the initial review letter: some felt it clearly explained what was going to happen while others felt it did not.

Clients were generally positive about their interactions with Social Security Scotland staff. However, a lack of updates on the progress of their review increased clients’ worry and stress about the outcome.

Policy commitment: Reviews, where required, are right first time

Summary of client experiences in relation to reviews: It was not within the remit of this research to comment on whether decisions were right first time or not. The research can only comment on client perceptions of the decision.

Those who received an outcome that met or exceeded their expectations felt the decision was right. Those who did not receive an outcome they had hoped for felt disappointed; while some acknowledged that the decision was fair, others did not think that their circumstances had not been fully considered.

Policy commitment: Reviews, where required, are undertaken in line with relevant policy commitments (e.g. decisions will be person-centred, reviews will be light-touch and, as far as possible, minimise stress)^[6]

Summary of client experiences in relation to reviews: Clients described the review process as easier than they thought it would be. Social Security Scotland staff were widely viewed as helpful, friendly and reassuring. However, clients still felt worried about the process and, where there were issues (e.g. lack of clarity around timescales, uncertainty over backdating payments, communication errors or knock-on impacts on other benefits/support), this exacerbated feelings of stress and anxiety.