Ill Health and Disability Benefits Stakeholder Reference Group: October 2017

Attendees and apologies

Present

• Nikola Plunkett, Chair, Scottish Government, Chair
• Kate Burton, NHS Income and Welfare Reform
• Donna Burnett, NHS Public Health Practitioner
• Dr Neil MacRitchie, BMA
• Ed Pybus, CPAG
• Graham Watt, University of Glasgow
• Jim Hume, National Rural Mental Health Forum
• Nicola Dickie, CoSLA
• Beth Hall, CoSLA
• Richard Gass, Rights Advice Scotland
• Yvette Burgess, CCPS
• Layla Thiener, DAS
• Kayleigh Thorpe, Disabled Children and Young People Advisory Group
• Rob Gowans, Citizens Advice Scotland
• Bill Scott, Inclusion Scotland
• Louise Whyte, Scottish Government
• David Taggart, Scottish Government
• Claire McDermott, Scottish Government
• Dr Mini Mishra, Scottish Government
• Catherine Henry, Scottish Government
• Ruari Sutherland, Scottish Government
• Leila Akhoundova, Scottish Government
• Caroline Keir, Castlerockedinvar Housing Association

Apologies

• Jeane Freeman MSP, Minister for Social Security
• Gerard McFeely, Occupational Therapy, NHS Lothian
• Jim Carle, Disabled Children and Young People Advisory Group
• Emilia Crichton, Director of Public Health
• Rachael McGruer, Scottish Government
• Ross Trotter, Scottish Government
• Dean Pemberton, Scottish Government
• Pat McAuley, Scottish Government

Items and actions

Welcome and Introductions

1. The chair welcomed the group to the meeting. SG analysts were in attendance to present their paper on the International Comparison of Disability Benefits. Claire McDermott was introduced as the incoming chair – she will take up this role at the next meeting of the group.

Minutes and SG Update

2. Minutes from the previous meeting were agreed.

3. Members had received a written SG update with the papers. No comments were received.

International Comparison of Disability Benefits

4. SG analysts provided an overview of their research report which discusses International Comparison of Disability Benefits. A comparison of 6 nations (France, Denmark, Norway, Sweden, Ireland, New Zealand), which were chosen on the basis that they had benefits which were comparable to AA, PIP and DLA.

5. A brief overview of each of the six comparable nations was provided to inform the groups discussions. The full report was circulated to the group in advance. During their overview of the report, SG analysts advised that this is not a like-for-like comparison. Equivalent benefits in comparator countries were shown to have a far more limited reach than UK extra-costs benefits. Potentially progressive aspects of those benefits must be understood in this context, and the limitations of such findings should be noted.

6. The group discussed which countries were effective in reaching target demographics and which challenge or evaluation mechanism could be used to further the research by demonstrating which approach yielded the most desirable outcomes. It was noted that this cannot be established from this report, which aimed to examine the process and key aspects of each approach within different countries. To come to an overall conclusion on effectiveness would be much more difficult, as countries have varying definitions of disability, wider systems of support and societal contexts. A separate commission would be necessary to address this point fully – requiring further analytical resource commitment.

7. It was noted that these nations will be facing different issues to those which we face in Scotland, and will also have varying levels of taxation and private healthcare which may have an effect on benefit requirement. It was agreed that amendments would be made to include key information on the socio-economic context for each comparator country.

8. Members requested information on nations which had been discarded from the report and the justification for this. It is noted that that this information is already set out in the report, but if required can be expanded.

Action: SG to add amendments agreed and give further consideration to other suggestions made by the group.

Duration of Awards

9. Rob Gowans, Citizens Advice Scotland presented the report and recommendations developed by the Duration of Awards Sub-Group, advising that the next steps would be to engage with the Experience Panels. The recommendations include having rolling awards to allow for longer periods before review, and that these reviews will be based on prognosis of the claimant’s conditions (5 years for permanent or progressive conditions) without a full reassessment at review. This also allows for the recipient’s award to continue throughout their review period, instead of stop as they do under a fixed term benefit such as PIP. CAS advised that he was scheduled to meet with the Chair of the Expert Advisory Group to discuss the recommendation in the report. There was some discussion about the process for dealing with a change of circumstances such the ability backdate awards when a person’s condition deteriorates and likewise the for consideration of safeguards where a person’s condition improves.

10. There was some discussion about the requirement to set out what assumptions about the wider benefits the group were working to in developing the recommendations. The chair advised that initially, given the need for safe and secure transition, Scottish PIP will be an improved version of the current benefit. The Minister has longer term ambitions for more radical change in the future, but such change would be beyond this parliamentary term.

Action: CAS will take back comments from the Reference Group to the Duration of Awards workstream for consideration.

Experience Panels Research Plan

11. SG officials gave an overview of Experience Panels, which were established to ensure users are at the heart of Social Security in Scotland. They have recruited 2400 volunteers, with expressions of interest still being received. As recruitment will reopen in 2018, SG officials welcomed recommendations on how the widest range of people can be reached.

12. Survey and focus group findings are not yet finalised, however an overview was provided of what had come out to date and committed to sharing the full findings in due course.

13. Following the update there was some discussion about the requirement for demographic information. It was advised that to date panel members did not want to us to ask about demographic information. The group expressed concern at this as lack of information, due to the difficulty in identifying under-represented groups. It was noted that the SG must first build trust with panel members, and that the SG are seeking to access this information in the future.

14. The group were assured that although under 16s are not on the panel for ethical reasons, parents of disabled children are on the panel. Similarly, people who have had claims and appeals rejected are also represented.

Action: SG to share experience panels user research findings when available.

Financial Advisors in GP Surgeries

15. An overview of the initiative, which sees Financial Advisors embedded in GP surgeries, was provided by a healthcare professional in the group. The key findings from projects in Edinburgh, Dundee and Glasgow are that embedding a financial advisor with general practice increases the number of applicants for benefits, with an average benefit of £7000 per annum per person, without generating additional work for the practice and thus freeing up time for clinical work.

16. The approach was said to provide a solution to the otherwise intractable problem of how to engage with general practices, making use of their cumulative knowledge and contact with patients and the also the familiarity and acceptability of the practice setting.

17. The group discussed a key concern depending on whether embedding financial advisors in general practice is seen as additional to current arrangements requiring additional resource or as a more effective alternative, requiring redistribution of resource. It was recognised that a combination of approaches is needed to reach different target groups.

18. It was explained to the group that this initiative allows Financial Advisors access to full medical records (at the discretion of patients), and therefore allows more effective advice to be given.

19. It was agreed that discussions about a strategic approach should be picked up with Donna in her new role to take forward a review of advice services.

Action: Members with an interest to contact Donna to discuss the review of advice services.

AOB and agenda for next meeting

20. The chair welcomed members to submit suggestions for future agendas.

The next meeting will be held on the 12 December 2017 in Atlantic Quay, Glasgow.