Disability assistance in Scotland: analysis of consultation responses

1 Executive Summary

The terms of Part 3 of the Scotland Act 2016 gave effect to some of the recommendations of the Smith Commission and provided for the devolution of a range of social security benefits to the Scottish Government.

The Social Security (Scotland) Act 2018 was a major piece of devolved legislation passed by the Scottish Parliament with the intention of establishing a new social security system, based on a set of principles informed by public consultation and Parliamentary scrutiny. Social Security Scotland, an Executive Agency of the Scottish Government, was subsequently established in 2018. From 2020, Disability Assistance will begin to be delivered by the Scottish Government.

On 5 March 2019, the Scottish Government published a consultation – Consultation on Disability Assistance – setting out the Scottish Government’s current policy proposals for three disability benefits. This consultation sought the views of all people, including those with living experience or a working knowledge of social security. Feedback from the consultation will inform the drafting of regulations for each form of Disability Assistance and the implementation and delivery of these benefits. The consultation closed on 28 May 2019.

1.1 Respondent Profile

In total, there were 263 replies to the consultation, of which 74 were from organisations (broken down as below) and 189 from individuals. Scottish Government officials also held a series of engagement events to raise the profile of the consultation, and to encourage participants to take part in the consultation. Where participants provided feedback and consented to its use, those responses were provided and considered as part of this report.

Table 1: Respondent Groups

	Number
Campaigning / Advocacy	13
Local authority	14
Third sector	40
Other	7
Total organisations	74
Individuals	189
Total respondents	263

1.2 Key Themes

A number of key themes were evident across questions as well as across respondent groups and summaries are provided below, rather than being outlined at each of the questions.

Views were broadly positive about the proposals laid out in the consultation paper, and a majority of respondents agreed with most of these proposals, including offering greater flexibility within the system and consideration of clients’ needs on a case-by-case basis, although some respondents noted the importance of ensuring the proposals as outlined are achieved. A common thread throughout responses was the need to avoid the anxiety and stress potentially caused by having to undergo assessments, as well as the need to avoid financial hardship. Notwithstanding this broad agreement with the proposals, key themes emerged as follows:

• One thread, primarily from organisations, was criticism of the current, reserved social security system and concerns that the proposals do not go far enough in creating the change required to deliver the social security system envisaged.
• While there was agreement of a need for a person-centred approach, some respondents commented generally that the proposals did not appear to go far enough to offer this.
• While a majority of respondents agreed with the suggested names for the benefits, some felt that the suggested names were not inclusive. For example, it was felt that use of the word ‘disability’ is potentially divisive or discriminatory, in that it can segregate clients who do not like the label ‘disability’. There were some requests for the names to focus on a social model that is perceived to be more inclusive.
• While there was general support for each of the benefits, there were some requests for one single lifelong disability benefit that is continuous and automatic with no distinctions based on age, rather than having three benefits for different age groups. For example, some respondents had concerns this could cause problems in managing the transition from one age group to another, while some noted that the definition of a young person can be subjective. Allied to this, there was agreement that benefits need to be related to need rather than age, and offer equality of access to all. Additionally, there were some requests for a mobility component to be offered to all clients.
• Overall, there was support for the role outlined for Case Managers in making decisions about entitlement for Disability Assistance, although some respondents wanted to know more about the training and guidance that would be required for Case Managers to make appropriate.
• Similarly, while there were high levels of support for Specialist Advisors and Assessors, some respondents sought clarity about the training and skills that would be required in order for both to provide accurate advice about the impact of an individual’s health conditions.

1.3 Consultation Questions

The following paragraphs summarise the main findings from each of the consultation questions.

1.4 Disability Assistance in Scotland (Qs 1-6)

A majority of respondents agreed with the proposed new names of the three forms of Disability Assistance. That said, some respondents noted a dislike of the words ‘disability’, ‘assistance’, ‘working’ ‘older’ and ‘pension’ as these were perceived to be potentially divisive or discriminatory. There were also some comments that these names are too long and that the acronyms are not easy to use. There were some requests for the names to focus more on a social model that is perceived to be more inclusive. A few respondents suggested there should be a common name across all three benefits.

Main Findings: Applying for the Benefit (Qs 7-8)

A large majority of respondents agreed with the proposal to enable multiple application channels for Disability Assistance, with a key theme being that there is a need for choice in application channels in order to offer an inclusive system and meet the varying needs of clients.

Main Findings: Conditions relating to Residence and Presence (Qs 9-10)

A majority of respondents who gave an answer agreed with the proposal to broadly replicate the current temporary absence rules, although some felt that clients should not lose their benefits if they live with their family abroad or that clients should have the right to go travelling without losing access to their benefit. There were some suggestions that more cover for temporary absence is required.

Main Findings: Making Decisions about Entitlement (Qs 11-17)

There was consensus with the proposal to implement a person-centred approach to making decisions about entitlement to Disability Assistance by Case Managers. Some respondents sought more detail about the type of training provided to Case Managers to ensure consistency when making decisions about entitlement.

A large majority of respondents agreed with the proposed approach to the involvement of Specialist Advisors (SAs) in supporting the decision-making process, although there were comments on the need to ensure that the views of healthcare professionals are considered, and some respondents would prefer to see more detail on the future training provided to SAs. There was some reference of a need to work closely with third sector organisations, health professionals and clients and / or their carers.

A wide range of situations were cited as needing to be taken into account by Case Managers as to when an SA should be involved. The most frequently mentioned were complex / rare conditions, fluctuating conditions, multiple illnesses and instances where specialist knowledge is required.

A large majority of respondents agreed that the decision-making process for Disability Assistance for Children and Young People, and for Older People, will use existing sources of information and not face-to-face assessments, although a few respondents felt existing sources of information might be insufficient. Some respondents were critical of the age boundaries suggested and felt that the same criteria should apply to all clients. There were also some comments referring to a need for client choice and providing capacity to request an assessment.

Main Findings: Approach to Supporting Information (Q18)

Respondents cited a range of supporting information that would be relevant in assessing an application for Disability Assistance. The most frequently cited included reports from:

• General practitioners, consultants and specialists;
• Social workers; and
• Carers.

Main Findings: Duration of Awards (Qs 19-24)

A majority of respondents agreed with the proposal to have no set award durations but to set an award review date that takes account of the likelihood of that person’s needs changing when a decision on a Disability Assistance application is made. There were a number of comments stating that if an initial assessment advises there will be no improvement in an individual’s condition, this should be sufficient reason not to review at any point in time. A majority of respondents also agreed with the proposal to set an award review date 5-10 years in the future for a person with a condition that is unlikely to change, although there were a number of comments that there should be indefinite lifetime awards if an individual has a long term condition that is unlikely to change.

A large majority of respondents agreed with the proposal that a change of circumstances should be defined as a change which has an impact on the level of assistance that a person receives. However, there were some calls for a broader definition than that supplied in the consultation paper; and reference to the fact that some clients are unsure of what would constitute a change of circumstances that needs to be reported.

Main Findings: Redetermination and Appeal (Qs 25-28)

A majority of respondents agreed with the proposal that clients have 31 days to request a redetermination, although amongst the organisations that responded, slightly more disagreed than agreed. However, a number of respondents cited instances where more than 31 days may be required and there were requests for flexibility depending on, for example, the need to access professional support or external services, or because of hospital stays.

A majority of respondents also agreed that Social Security Scotland should have a period of between 40-60 days to consider a redetermination of Disability Assistance, although again the views of organisations were split, with some indicating that this timescale is too long.

Main Findings: Short-term Assistance (STA) (Qs 29-38)

A majority of respondents agreed that STA should not be paid to people who are not living or present in Scotland, although there were comments that this should depend on individual circumstances.

A large majority of respondents agreed that STA should not be recoverable except where it is later established that the principal assistance type was claimed fraudulently, although some respondents felt there would need to be clear evidence of deliberate fraud.

A majority of respondents agreed that STA should not be available where an investigation by Social Security Scotland has determined that the original payment was claimed fraudulently. Respondents agreed that there should be a right of appeal against any decision by Social Security Scotland that Disability Assistance had been claimed fraudulently. Additionally, some respondents indicated that if a client’s circumstances change, such that they do meet the eligibility criteria in future, this should not preclude them from claiming Disability Assistance.

A majority of respondents agreed that any deductions being made from an on-going assistance type to service an overpayment liability should also be applied to STA. However, there were also some comments that STA should never be reduced as it provides a financial safety-net, and that there is a need to give consideration to the risk of financial hardship and possible impacts on mental health and wellbeing.

A majority of respondents disagreed that for successful process decision appeals where the tribunal has overturned Social Security Scotland’s decision, STA should become available at the point the decision is overturned rather than the date of the original request. Many respondents noted that STA should become available from the date of the claim when eligibility started, or that payments should be backdated to the date of the original decision. There were also comments that a client should not be disadvantaged financially because of a mistake by Social Security Scotland.

Main Findings: Breaks in Disability Assistance (Qs 39-40)

Views were relatively split as to whether where there is a break in a client’s eligibility to receive the benefit in certain circumstances, they will cease to receive the benefit. The key theme was that there should always be financial support for those with a disability as they will still have everyday costs and removal of the benefit will leave people at risk of serious financial hardship. There was also some reference to the need to consider carers, who are still likely to be supporting the client.

Main Findings: Comments or experience of overpayment recovery (Q41)

Key themes emerging at this question were that current level of deductions are set too high by the Department for Work and Pensions and are expected to be repaid too quickly; that the current system causes severe financial hardship and that repayments should be at a level that is affordable to clients.

1.5 Disability Assistance for Children and Young People (DACYP)

Main Findings: Entitlement to DACYP (Qs 42-43)

There was broad agreement with the proposal to provide entitlement to Disability Assistance for Children and Young People to clients aged 0-18 years (initially the upper age limit will be set at 16 until delivery of Disability Assistance for Working Age People commences). However small numbers of respondents suggested the age bracket should be extended to allow for ease of transition for those aged between 16 and 21.

Main Findings: Young People aged 16-18 (Qs 44-47)

There was broad agreement with the proposal to extend eligibility, for those already in receipt of Disability Assistance for Children and Young People before the age of 16, to age 18.

A majority of respondents agreed with the approach to eligibility rules for the different components of Disability Assistance for Children and Young People, although there were a few comments that eligibility criteria do not reflect some situations accurately. For example, many respondents felt that age 16-18 is a difficult period with some challenging transition points, and that making significant life choices can be difficult for some clients; many also felt that the age eligibility could be extended to the age of 21 for those in full time education.

Main Findings: Winter Heating Assistance (Qs 48-49)

The large majority of respondents agreed with the proposal to make a £200 Winter Heating Assistance payment to families with a child in receipt of the highest rate of the care component of Disability Assistance for Children and Young People. There were some suggestions that this payment should be available to all people receiving any form of social security benefits or Disability Assistance.

1.6 Disability Assistance for Working-Age People

Main Findings: Benefit Rules: Activities and Descriptors (Qs 50-53)

A majority of respondents agreed with the proposal to use a points-based system to assess eligibility in relation to Disability Assistance for Working-Age People, although there were some comments that a points-based system lacks flexibility, particularly in relation to fluctuating conditions. Significant numbers of respondents felt that points-based systems have already been discredited, and that a ‘one size fits all’ approach is inappropriate.

When asked what suggestions they had about the most appropriate way to assess eligibility in relation to mobility for Disability Assistance for Working-Age People, respondents tended to focus on the use of medical consultants, general practitioners, experts and specialists and their reports and evidence. There was also agreement of a need for a person-centred approach and reference to the client’s own evidence, as well as seeking more information about the skills that would be required by Assessors to make an appropriate assessment of the impact of an individual’s health condition.

In terms of the full list of descriptors currently used to assess claims for Personal Independence Payments (PIP), the key themes were that the descriptors do not make sufficient allowance for clients with mental health conditions and are geared towards those with physical disabilities. There were also requests for the descriptors to be changed so they more properly reflect the impact of disabilities on daily lives as opposed to functional ability.

Main Findings: Assessments (Qs 54-59)

A wide range of informal observations made by assessors as part of a face-to-face assessment were considered to be inappropriate. These included observations relating to personal appearance, behavioural observations and movement, strength and sight tests. There were also some comments on the need for face-to-face assessments to be conducted by trained or experienced assessors with a good understanding of the condition being assessed.

In terms of what are considered acceptable distances to travelling to an assessment centre, there was little consensus, although there were comments on the need for assessments to be local to clients. Respondents also pointed out that the ability to travel is dependent on specific conditions and that this needs to be considered on a case-by-case basis.

When asked what other circumstances should be taken into account in relation to travelling to an assessment, respondents focussed on whether a carer or other support is needed, the impact on clients of having to travel and the availability and accessibility of transport options. There were also suggestions that some specific conditions should not require a face-to-face assessment.

Many respondents felt clients should be able to reschedule an appointment three times, although some respondents preferred for rescheduling to have no limits or that rescheduling should depend on the reasons for cancelling or the client’s condition.

Respondents outlined a number of criteria that would amount to exceptional circumstances for failing to attend an assessment, including hospital admissions, bereavement, carer or support issues and transport issues. Again, there were some suggestions that these needed consideration on a case-by-case basis.

A large majority of respondents were positive about the audio recording of assessments, although some made caveats such as a requirement for the client’s consent.

1.7 Disability Assistance for Older People (DAOP)

Main Findings: Eligibility (Qs 60-64)

A large majority of respondents agreed with the proposal that Disability Assistance for Older People is provided to individuals who have reached state pension age or above. As with the other two forms of Disability Assistance, there was some reference to the need for one disability benefit covering all age groups.

A majority of respondents agreed with the proposed eligibility criteria for DAOP, although there were some concerns over the lack of a mobility component and several requests for this to be included, primarily from organisations.