Independent Review of Adult Disability Payment (ADP): Analysis of responses to a public consultation and call for evidence

4. Pre-application support for Adult Disability Payment applications

This chapter explores experiences with two new services created by the Scottish Government and Social Security Scotland to assist people in applying for Adult Disability Payment.

The Local Delivery Service (LDS) works in every local authority in Scotland, providing people with support with their Adult Disability Payment application. Advisers are trained and can work with people at times and in places that suit them, for example, at a person’s home, at a venue in the local community, in a hospital or prison, on a telephone call or on a video call.

The Scottish Government has also provided funding for an Independent Advocacy Service. They have appointed VoiceAbility to deliver this service. More information on both these services can be found in the consultation and call for evidence papers.

As noted below, awareness and usage of both services among consultation respondents was relatively low, and therefore a limited number of comments were provided. Although some individuals described their experiences, it was often unclear what type of support they had received or whether they had been supported by the Local Delivery Service or the Independent Advocacy Service. In some cases, it is possible they were referencing interactions with case managers or other Social Security Scotland staff.

Key findings

• One in ten (11%) consultation respondents reported they have used the Local Delivery Service and one fifth (19%) of those who had not used the service were aware of it. Fewer than one in ten (6%) consultation respondents had used the Independent Advocacy Service. Many acknowledged that greater awareness of these services and what they do was needed. Recommendations for outreach included greater advertising, social media outreach and more information on the Social Security Scotland website.
• Consultation respondents who used the Local Delivery Service reported a positive experience with their adviser and appreciated that the meeting could be held in a preferred location. Similarly, those who had used the Independent Advocacy Service felt that they had been fairly treated. A few consultation respondents mentioned long wait times and trouble accessing these services as barriers to uptake.
• Participants at engagement events described more mixed experiences. Some described the staff as helpful and personable, while others highlighted difficulties with the referral process and trouble getting appointments.
• Call for evidence responses also provided feedback on the pre-application services and support. A few reported that the services worked well. Others suggested the following changes: improved staff training, better access to help such as dedicated telephone lines, greater interaction with third-party organisations; and ensuring the impartiality of the advice offered.

Consultation – Local Delivery Service

One in ten (11%) consultation respondents who answered reported they have used the Local Delivery Service for help with something to do with Adult Disability Payment. Among those who had not used the Local Delivery Service, one fifth (19%) indicated they were aware of the service and the support it offers, while the remaining two fifths were either unaware or unsure.

Among those who answered Q4C, 43% felt they had been treated well, though 39% were unsure. However, the number of respondents answering this question was higher than the number who reported they have used the Local Delivery Service. It may be that these respondents misunderstood this question, which came early in the consultation, and were answering in relation to the application process more generally. Others may have misunderstood the instruction and responded if they had answered ‘yes’ to Q4B.

Q4D. If you said “yes”, how easy was it to access the Local Delivery Service?

Q4E. Please provide reasons for your answer.

Among those who answered Q4D, there were mixed views on ease of accessing the Local Delivery Service. One third (36%) felt it was easy, one quarter (24%) difficult and 41% neither. Again, more respondents answered this question than indicated they had used the Local Delivery Service at Q4A. It is possible that some answered because they found it difficult to access the Local Delivery Service and therefore did not use it. Others, however, may have been confused about whether they were answering in relation to ‘yes’ they had used the Local Delivery Service (Q4A), or ‘yes’ they felt they were treated fairly (Q4C).

Lack of awareness

A quarter of consultation respondents provided an open comment at Q4E. Most commonly, respondents highlighted a lack of general awareness of the Local Delivery Service or expressed confusion about how it worked and the services they offer. This sentiment was echoed at multiple engagement events.

“I am not aware of these organisations and I feel they should have been promoted more as I know a lot of family and friends are definitely not aware of these types of help.” – Individual

Positive experience

Some respondents described their positive experience of making an appointment with the Local Delivery Service. They found making an appointment straightforward and noted that the Local Delivery Service advisor met them at their preferred location for their meeting.

Multiple appointments

While happy with their experience with the Local Delivery Service, a few respondents highlighted that because their Adult Disability Payment application was very long they required multiple appointments with the service. While there were issues with the length of the process, these respondents were happy with the flexibility of Local Delivery Service advisors in assisting them.

Long wait times

Two mentioned that long wait to start using the service meant that they were unable to seek assistance from the Local Delivery Service and used other resources instead. Two respondents noted difficulty contacting the Local Delivery Service. One spoke of long waiting times on the phone, which led them to hang up on the call, and another mentioned that they felt the Local Delivery Service in their local authority was understaffed and unable to provide the needed assistance.

Experience of the Local Delivery Service among event participants

There were mixed views of the Local Delivery Service among event participants. One described receiving helpful support from their Local Delivery Service after they had encountered difficulties with their application and felt this support should be offered proactively by Social Security Scotland rather than waiting until problems arise. One organisational representative commented that when the information, advice, and assistance provided by the Local Delivery Service are accurate the service works well. Staff were described as personable and helpful, and less adversarial than DWP. Organisational participants at one event also appreciated that someone from their Local Delivery Service had come to speak to them and signposted them to useful courses.

Conversely, some described negative experiences such as a difficult referral process, difficulty reaching staff on the phone, a lack of available appointments, staff lacking experience, training and knowledge, and a request to meet with someone along with their carer not being taken into consideration.

Q4F. What do you think would help make people more aware of this service and the help it provides?

Just under half of consultation respondents provided an open comment at Q4F. The most prevalent theme, mentioned by many, was that Social Security Scotland should increase and improve the promotion of the Local Delivery Service. This was mentioned quite broadly without specifying the best channels or recommending any particular methods for promotion. However, many respondents agreed that the service sounded beneficial.

“More advertising of these organisations and how they help. This sounds a fantastic way to help people and a more supportive way and should be more promoted to the community and to the wider public.” - Individual

Several respondents did, however, suggest options for promotion. Some recommended social media and some others thought that advertising the service on the Social Security Scotland website, on all Adult Disability Payment-related mailings and in community settings, such as GPs surgeries, would be most effective.

Consultation – Independent Advocacy Service

Only 6% of consultation respondents who answered said they had used the Independent Advocacy Service for help with something to do with Adult Disability Payment.

Among those who had not used the Independent Advocacy Service, 15% were aware of the service and the support it offers, while the remaining 85% were unaware.

Among those who answered Q5C, 47% felt they had been treated well, with the remaining 53% unsure. However, the number of respondents answering this question was higher than the number who claimed to have used the Independent Advocacy Service. It may be that these respondents misunderstood this question and were answering in relation to the application process more generally. Others may have misunderstood the instruction and responded if they had answered ‘yes’ to Q5B.

Q5D. If you said “yes”, how easy was it to access the Independent Advocacy Service?

Q5E. Please provide reasons for your answer.

Among those who answered Q5D, two thirds (66%) felt it was easy to access the Independent Advocacy Service and one third (33%) were neutral. Again, a few more respondents answered this question than indicated they had used the Local Delivery Service. It is possible that these respondents may have been confused about whether they were answering in relation to ‘yes’ they had used the service (Q5A), or ‘yes’ they felt they were treated fairly (Q5C).

One in six consultation respondents provided an open comment at Q5E. The most prevalent theme was uncertainty about the Independent Advocacy Service and what it offers. These respondents had not heard of the service before responding to this consultation. Two others mentioned they had not used it but did not clarify if that was because they had not heard of it or did not need it. One respondent described an instance where a friend had been able to get an appointment, but it was too late for her to meet the deadline for a re-determination.

Q5F. What do you think would help make people more aware of this service and the help it provides?

Two-fifths of respondents provided an open comment at Q5F. The most prevalent theme, mentioned by many, was a request for more promotion of the service generally. Some suggested that the Independent Advocacy Service could be publicised on social media, TV, radio, and at local council offices, Jobcentres, community centres, GPs surgeries and at Citizens Advice Bureaux around Scotland. Some others suggested that direct links to the service be provided on the Social Security Scotland website, as well as in all communication about Adult Disability Payment.

Two respondents noted the importance of correct staffing levels to ensure that the level of service being offered via the Independent Advocacy Service is deliverable. As with Local Delivery Service, this related to the respondent’s difficulties contacting the service via the telephone.

Call for Evidence

Thinking about the pre-application services provided by Social Security Scotland, can you provide specific examples of:

Q4A. Parts of those services that are working well?

Q4B. Parts of those services that don’t work, are confusing or could be further improved?

Just under half of call for evidence respondents commented at Q4A and just over half commented at Q4B. In these initial questions, respondents covered all aspects of pre-application services, including those delivered by Social Security Scotland.

Working well

A few respondents emphasised that Social Security Scotland staff were helpful when their clients called with questions. One Parent Families Scotland and MS Society Scotland specifically mentioned Local Delivery Service staff as providing positive input into their client’s application. MECOPP and Citizens Advice Scotland emphasised that home visits are a very useful aspect of the services provided by the Local Delivery Service. They noted that face-to-face visits often helped clarify a person’s needs and helped those people who did not or could not communicate on the phone.

In terms of accessibility, Feniks and Age Scotland noted the success of the language support and interpretation services offered by VoiceAbility and Social Security Scotland respectively. Another anonymous organisation mentioned that the online application submission process is working well for those who have access to computers and a certain level of digital literacy.

Improved staff training

Some felt that improved staff training is required, particularly to address a lack of awareness of certain conditions and the impacts they have on daily living. References to improved staff training included the services provided in the pre-application process, i.e., the Local Delivery Service and VoiceAbility, as well as case managers and staff working the phone lines at Social Security Scotland. For example, Cerebral Palsy Scotland noted that one in four people with Cerebral Palsy are unable to speak. They use alternative methods for communicating, including high-tech aids, and often feel that Social Security Scotland staff are not able to communicate with them successfully.

In response to Q5B, Epilepsy Scotland and FAIR Ltd, mentioned they would not necessarily recommend people to the Independent Advocacy Service as they believed the service could not offer the same level of support that they provide to their clients, due to having less knowledge or experience of either certain conditions or procedural advice. Similar concerns were raised in the engagement events. Participants spoke about receiving inaccurate advice from the service and feeling that staff lacked experience and a limited understanding of case law.

“People do not need an advocate who cannot advise. This needs to be looked at. Funding needs to be diverted to advice services for disabled people. The term advocacy is not being used in the correct way and it [is] not the correct service to access benefits. People need Welfare Rights Advice to access their rights and entitlements.” – FAIR Ltd.

Better access

Improved access to Social Security Scotland staff through dedicated telephone lines was suggested, as respondents mentioned that lines were often busy with very long waiting times. An anonymous organisation noted the importance of phone access for those who struggled with digital literacy.

Other respondents mentioned clients having difficulty contacting the pre-application services. Citizens Advice Scotland held a round table held with stakeholders which noted that there should be alternative referral pathways to enable organisations, like CABx around Scotland, to refer their clients directly to the pre-application services or to improve the provision of drop-in sessions in communities.

Other improvements to communication mentioned by a single individual respondents included better tracking of the application process, an application dashboard, and a concern that pre-application support does not work for people who do not have access to a telephone or do not like answering the telephone.

Impartiality

Another specific point mentioned by MS Society Scotland was a concern about the impartiality of the pre-application services that are funded by either Social Security Scotland or the Scottish Government, which increased mistrust in the services provided. Mistrust of the Independent Advocacy Service was also mentioned during the engagement events for the same reasons mentioned above. Participants noted that they and the people they support expressed greater confidence in approaching third-sector organisations, which they thought were more likely to consider their best interests. There were calls to make it clear that the Independent Advocacy Service delivered by VoiceAbility is independent from Social Security Scotland.

Interaction with third-party organisations

One Parent Families Scotland and one anonymous organisation emphasised the importance of providing implicit consent to advocacy organisations, in the same way as it was used for Personal Independence Payment under the DWP. One Parent Families Scotland also suggested that Social Security Scotland develop a transfer pathway with local third-sector organisations for those who may not feel comfortable using the Local Delivery Service or VoiceAbility due to fears of impartiality.

Lack of awareness and experience

Some could not provide evidence because their clients and research participants did not have experience or awareness of pre-application services. As with comments from consultation respondents, more promotion of the services was recommended.

Q5A. What evidence exists about the impact of Social Security Scotland’s Local Delivery Service in supporting people making an application for Adult Disability Payment

Positive impacts

The most prevalent theme in response to Q5A was that evidence highlights that the Local Delivery Service has provided a number of positive impacts for those applying. While a few respondents recounted positive experiences more generally, a few others mentioned specific aspects of the service that worked. These are listed here from most to least prevalent:

• The MS Society Scotland and SAMH, who both spoke with key stakeholders in preparation for this consultation response, suggested that the LDS reduced the stress of applying for some respondents.
• The MS Society Scotland also noted that they heard feedback that the LDS was helpful in gathering information for the application that the person may not have considered relevant.
• SAMH noted that it also assisted those who may struggle with digital exclusion as LDS staff members were able to collect information orally.

“The local delivery team were described as helpful in mitigating the distress caused by completing the ADP application, particularly where the applicant has a history of trauma. For example, link worker staff stated that people that use our services had told them that the volume and detail of information required in an application for ADP can be triggering, especially those who are writing down the symptoms they experience as a result of trauma. One person we support felt unable to have the physical copy of their evidence and application form within their house as seeing their experience in written form was triggering for them. This has been mitigated with support from the local delivery service, as the service can visit applicants and take evidence for the application orally.” – SAMH

Accessibility issues

One Parent Families Scotland and SAMH have both heard from key stakeholders that timely access to the Local Delivery Service could be difficult, although they noted that experiences varied across the country.

Less commonly mentioned themes:

The following concerns were mentioned by a small number of respondents:

• Issues surrounding identity checks, particularly for people working with addiction services or living in temporary accommodation.
• Child Poverty Action Group in Scotland noted that one stakeholder mentioned instances where people had applied and received a decision based on inaccurate application information. They believed that their application did not reflect what they had communicated to the Local Delivery Service staff member. They suggested that the Local Delivery Service provide applicants with the option to access their completed application.
• Participants in one event mentioned that some of the people they support may not want another professional involved in their application and highlighted the challenges they face having to retell their story multiple times.

Lack of awareness

As mentioned at the previous question, some respondents cited a lack of awareness of the Local Delivery Service among their stakeholders, or a lack of uptake of the service so far. This limited their ability to provide evidence at this question.

Q5B: What evidence exists about the impact of the Independent Advocacy Service in supporting people making an application for Adult Disability Payment.

Just under one third of respondents provided a comment at Q5B. However, some noted that due to limited awareness and uptake of the service, they could not provide evidence at this question. Others described what worked well or less well with the Independent Advisory Service, with these comments included in the analysis of responses to Q4A and Q4B above.

Q6. What evidence exists about what factors influence people approaching third sector or other public sector services for support with Adult Disability Payment?

Over two thirds of call for evidence respondents provided a comment at Q6. While organisations did not provide specific examples of existing evidence they contributed their understanding of the factors that lead people to their own, other third sector or other public sector services for support with Adult Disability Payment. These are listed below from most to least prevalent:

• Application literacy and assistance: respondents spoke of clients coming to their benefits services due to digital literacy issues, language barriers or confusion regarding the application wording.
• Accessibility: people who struggle to get through to the Local Delivery Service or Independent Advocacy Service often turn to their local third-sector or local authority teams for assistance.
• Knowledge: respondents noted that their services are often used due to their experience with the Adult Disability Payment application process or due to their insight into specific conditions which can help with the Adult Disability Payment application.
• Trust: organisational respondents noted that they work with many potential Adult Disability Payment clients on other issues and have already established trust with them, their families or their communities. In some cases, new contacts have come via word of mouth due to prior known successes with the Adult Disability Payment application. In contrast, Glasgow City Council noted that they may be approached due to a mistrust of Social Security Scotland.
• Re-determination or appeal assistance: Others noted that some people turn to third sector organisations or local authorities after they have had their initial application refused.
• Stress and anxiety: one individual and Citizens Advice Scotland suggested that people turn to their services due to the stress of the application process or previous trauma associated with Disability Living Allowance or Personal Independence Payment applications.
• Media and advertising: Age Scotland noted that after media stories about Adult Disability Payment, they often receive general enquiries about Adult Disability Payment on their helplines.