Disability benefits - supporting information: qualitative research

1. Introduction and methods

Introduction and background

The Scotland Act (2016) devolved some social security powers to the Scottish Government for the first time. Most of these relate to disability benefits and carers' benefits. Social Security Scotland, the organisation responsible for the delivery of these benefits, was set up in 2018 and the programme of devolution is expected to be completed by 2025/26.

In July 2022, the Scottish Government commissioned Ipsos Scotland to undertake qualitative research into the role of supporting information in the delivery of two devolved disability benefits:

• Child Disability Payment (CDP), which replaces Disability Living Allowance for children administered by the UK Department for Work and Pensions (DWP), and was rolled out across Scotland in November 2021, following a pilot that started on 26 July 2021.
• Adult Disability Payment (ADP), which replaces Personal Independence Payment (PIP) and Working Age Disability Living Allowance administered by DWP, and was rolled out across Scotland in August 2022, following a pilot that started on 21 March 2022.

The qualitative research focused on the role of supporting information in the application process rather than at the award review stage. This was because the fieldwork took place shortly after the benefits had launched and very few, if any, people would have experienced a review. However, the same supporting information policy applies to reviews so the learnings in this report will also apply to reviews.

This research is part of a wider programme of work evaluating the policy impact of the devolution of disability benefits, with the overarching aim to understand how a benefit is being implemented and what effects it has had, for whom and why. This wider work will provide insight into how benefits contribute to the delivery of wider Social Security principles and government objectives. More detail can be found in the Devolution of disability benefits: evaluation strategy.

The role of supporting information

In order to ensure a safe and secure transition from DWP delivering disability benefits to the launch of disability assistance in Scotland, the eligibility criteria for each form of disability assistance have initially remained largely the same as the benefits they replace. However, other important aspects of disability benefits have been changed significantly to allow the Scottish Government to take a human rights, person-centred, and trust-based approach to disability assistance. This is to ensure that the decisions are in line with the values of devolved social security: dignity, fairness, and respect. Policy commitments on these changes are outlined below.

Case Managers (see Glossary of job roles in Appendix 1) start by assuming that the applicant has provided an accurate account of how their disability or condition impacts them or their child. Following this trust-based approach, Social Security Scotland will not seek to gather an exhaustive list of supporting information to confirm every detail the applicant mentioned in their application form.

In line with the trust-based approach, supporting information is used to support staff in building up a holistic picture of the individual's circumstances and to enable them to make an appropriate decision. Supporting information is not used as 'evidence' or 'proof', which is reflected in the language and terminology used by Social Security Scotland when referring to supporting information.

There are two types of supporting information:

• Supporting information from a professional. This is supporting information from someone who, in their professional capacity, is familiar with the impact of the individual's condition and/or their treatment, care, or needs. This could include people who work in health or social care, education, or any other professional who is involved in the individual's treatment or care.
• Supporting information from an individual's wider support network. This can give insight into the impact the condition or disability has on the individual on a daily basis. This can include, amongst others, family members, partners, friends and unpaid carers (the mygov.scot website contains a more detailed list of examples of supporting information).

Note that statements drafted by the applicant themselves are not considered supporting information.

The role of supporting information from a professional and supporting information from the individual's wider support network are different.

Every applicant is asked to provide one piece of supporting information from a professional, where possible. The main role of this type of supporting information is to broadly confirm the individual's condition(s), disability, or level of need. This type of supporting information might also provide additional details on the impact the condition or disability has on the individual's day-to-day life.

Supporting information from the wider support network is likely to supplement the application by describing the individual's needs. It is not always required for a decision but can be critical in helping the Case Manager make a decision, especially where the application form does not provide enough information.

Case Managers should make decisions based on the balance of probabilities if they do not have all the information needed to establish the facts of a case. This means that a factual circumstance must be accepted as true if the information provided shows that it is more likely than not that it occurred.

Applicants can ask Social Security Scotland to obtain supporting information from professionals on their behalf. This is done by ticking the relevant box on the application form.

Applications can be made online, by post, or in person with the help of a Client Support Advisors who work for Social Security Scotland in local delivery teams across Scotland. Supporting information can be posted or uploaded online to the relevant space on the Social Security Scotland site.

Where supporting information is not available

An individual might be unable to provide the supporting information needed to make a decision because it does not exist or is unavailable. In these cases, where the individual has good reason not to be able to supply supporting information, the Case Manager has the discretion to make a decision without supporting information. Good reasons might include, for example, not being able to access a healthcare professional due to their condition or due to current waiting times. In those cases, the individual must not be treated less favourably for not having supporting information from a professional, and Case Managers should ensure every effort has been made to gather supporting information from a professional on the individual's behalf before making a decision.

Continuous improvement

Social Security Scotland is committed to continuous improvement and development (see the Social Security Scotland principles), so while the definitions and decision-making guidance etc. referred to in this report are accurate at the time of writing, these may change as improvements and developments continue.

Policy commitments

The following policy commitments have been made in relation to supporting information:

• Clear and accessible guidance on what supporting information is most useful. This includes internal guidance for Social Security Scotland staff and external guidance for applicants and other individuals providing supporting information.
• Case Managers (Social Security Scotland staff) work collaboratively with individuals to identify the most useful supporting information.
• Case Managers can gather supporting information on the individual's behalf.
• Supporting information only needs to broadly support application or review, rather than confirm every detail the individual has given in their application or review form.
• Case managers have discretion to make an award in the absence of supporting information.
• Generally, only one piece of supporting information is sought from a professional per application.
• Supporting information both from professionals and the individual's wider support network is accepted.
• The different types of supporting information are given equal consideration.

A logic model setting out how the approach is intended to contribute to positive outcomes for individuals is shown at Appendix 2. It should be noted that, while almost all the elements in the logic model have been covered by the research, the research was not structured around the model.

Aims of the research

The project sought to answer the following research questions:

1. Do applicants understand what supporting information they should or could be providing to support the decision-making process as much as possible?

2. Do applicants feel that their supporting information has been considered fairly?

3. What impact does supporting information have on Case Managers' decision-making process?

4. Is the process of requesting and obtaining supporting information done in line with policy commitments?

Methods

The research took a qualitative approach using semi-structured interviews. Information sheets, participant invitations, and discussion guides were drafted by Ipsos and sent to the Scottish Government for comment before being finalised. The perspectives and experiences of the following groups were explored:

• Applicants who had applied for CDP or ADP. Applicants were asked about their overall experience of the supporting information process as well as details of different elements including: their understanding of what was required; their interactions with Case Managers; any barriers they faced; what they thought worked well; and what they thought could be improved. They were also asked how they felt they had been treated by Social Security Scotland, the impact their experiences had on their perceptions of Social Security Scotland, and their likelihood of applying for other benefits in the future.
• Social Security Scotland staff involved in decision-making. These staff were asked for their perspectives on the applicant experience as well as the staff experience. They were asked about their role in the supporting information process; how supporting information was used in decision-making; what aspects of the process worked well; what challenges they encountered; and what they thought could be improved. They were also asked about the training, support, and decision-making guidance they have access to.
• Client Support Advisors who are employed by Social Security Scotland and work in local delivery hubs across Scotland. They support people to make applications.
• Third Sector staff in advice/support agencies who help people with applications.

These last two groups were asked about their experiences of helping applicants to provide supporting information, which aspects people had difficulty with, and which groups of applicants were most likely to need support. They were also asked what might improve the experience for applicants and what might help them to help applicants.

The full discussion guides are provided at Appendix 3.

Applicant interviews and quotas

We interviewed 42 applicants: 22 who had applied for CDP on behalf of their child, and 20 who had applied for ADP for themselves. All but five were successful in their applications. Further demographic details are shown in the table below. A total of 41 interviews were undertaken remotely by telephone or video call, depending on the participant's preference. In addition, by preference of the participant, one interview was undertaken face-to-face at their home. Interviews lasted around 45 minutes on average and, with the participants' permission, were recorded for analysis.

Fieldwork with applicants was conducted between 6 September and 17 November 2022. Their applications for disability benefits were submitted between 2 January and 1 March 2022 (for CDP) and between 21 March and 15 April 2022 (for ADP).

The aim of sampling in qualitative research is not to obtain a representative sample of the population of interest, but to obtain a mix of people with a range of different characteristics. This maximises the chance of identifying different issues. In this case, minimum quotas were set on age (for ADP applicants only); area deprivation; rurality; the nature of the condition (complex or multiple conditions, physical conditions, mental health conditions, learning/cognitive disability); ethnicity; and whether the application had been successful or not. All of the minimum quotas were met except that we were unable to recruit ADP applicants from the youngest group (aged 16-22) and we were only able to recruit one unsuccessful CDP applicant (against a target of three).

Profile of applicants interviewed

	CDP applicants interviewed	ADP applicants interviewed
Total interviews	22	20
Gender	[1]
Man		9
Woman		11
Age	[1]
23-35		3
36-50		8
51-state pension age		9
Rurality
Urban	17	15
Rural	4	4
Unknown	1	1
Deprivation
SIMD 1 or 2 (living in a more deprived area)	10	13
SIMD 3, 4 or 5 (living in a less deprived area)	11	6
Unknown	1	1
Health condition/disability (more than one may apply)
Physical health	10	16
Mental health	8	9
Learning disability/ cognitive impairment	17	6
Multiple or complex conditions	21	18
Ethnicity
Ethnic minority	2	2
Not from an ethnic minority	20	18
Application outcome
Successful	21	16
Unsuccessful	1	4

[1] Note that we did not set quotas on the gender and age of the children. This is because parents, guardians, or carers tend to apply on behalf of disabled children. The supporting information process is therefore more likely to be experienced by them.

Recruitment of applicants

Recruitment was undertaken through Social Security Scotland who emailed invitations and participant information sheets to those who had heard the outcome of their benefit application. Participants were offered £30 as a 'thank you' for their time. Those who were interested in taking part opted in by emailing or phoning Ipsos. Ipsos then responded via email or phone. Potential participants were asked a small number of questions to check that they were eligible to take part and whether they fitted the quotas. The questions included:

• A check that they had heard the outcome of their application.
• Whether the application was successful or unsuccessful.
• Their postcode (to enable us to check against area deprivation and rurality quotas).
• Age (for ADP applicants only).
• Their ethnicity.
• Broad information about the condition/disability such as whether it was a physical or mental health condition.

Staff focus groups/interviews

Thirty-one members of staff were included in the research. Fieldwork was conducted face-to-face in Social Security Scotland offices in Dundee and Glasgow in early November 2022.

Case Managers are responsible for processing applications, requesting and obtaining supporting information where necessary, and making decisions on entitlement. Overall, 18 Case Managers took part in mini focus groups with their peers. Nine worked on CDP cases and nine worked on ADP cases. Two groups were held with staff working in CDP cases and two groups were held with staff working on ADP cases. The discussions lasted around 90 minutes on average.

Decision Team Managers manage the Case Managers and are responsible, among other things, for Quality Assuring their work and keeping them up to date with any changes to policy or processes. Eight took part in individual depth interviews. Four looked after CDP Case Managers and four looked after ADP Case Managers. The interviews lasted around an hour on average.

Five Operations Managers were interviewed. Operations Managers oversee the work of Decision Team Managers. There were two individual depth interviews with ADP Operations Managers, one with a CDP Operations Manager, and one paired depth with two CDP Operations Managers. The interviews lasted around an hour on average.

Two video interviews were conducted with staff from advice and advocacy charities who provide support to applicants in relation to the overall application process, including supporting information. These interviews were carried out in December 2022 and January 2023.

The original plan had been to interview six representatives from advice and advocacy charities. However, despite contacting over twenty organisations multiple times, only two opted in to the research. We do not know the reason for the lack of response. To obtain more data from those advising individuals during the application process, we agreed with Scottish Government officials that we would instead interview four Client Support Advisors employed by Social Security Scotland. They work within local delivery teams and provide face-to-face, video and phone support to applicants. These interviews were conducted by video call in December 2022 and January 2023.

Analysis of the data

The analysis of the qualitative data took a systematic, thematic approach that was intended to produce findings that are transparent, methodologically robust, and are clearly grounded in participants' accounts. Our analysis included the following stages:

• After fieldwork was complete, the research team held an analysis meeting, during which we discussed the key themes that had emerged.
• We summarised each interview, using notes and transcripts, into a thematic 'framework matrix' produced in Excel. This framework showed individual participants along the rows and themes/discussion guide topics down the columns.
• Each theme/topic was then analysed. Researchers looked at the range of issues that had emerged and at any clear differences between participant groups e.g., between successful and unsuccessful applicants or between ADP and CDP applicants.

Limitations of the research

Firstly, only people who had completed an application were included in the research. We therefore cannot say anything about people who might be eligible but did not apply, and whether their reasons for not doing so relate to supporting information.

Secondly, the opt-in approach to recruitment is likely to have biased the sample to those more willing to take part in research and those more able to deal with administrative tasks (including people with higher levels of literacy; those less severely affected by their own or their child's condition, whether physical or mental; and those with less chaotic lives and with more resource or means to take part). Consequently, this also means the sample is likely to be biased towards those more able to supply supporting information. Indeed, most of the applicants we interviewed had supplied supporting information with their initial applications. We have no data on the exact proportion of all applications which arrive without supporting information, however, staff we interviewed indicated that the majority of applications that they deal with arrive without it.

Thirdly, our sample contains only five applicants who were unsuccessful. While this is not hugely out of line with the proportion of all applicants who are unsuccessful (based on ADP and CDP High Level Statistics), it is a small number from which to draw conclusions. This should be borne in mind when reading findings related to unsuccessful applicants.

A note on the reporting of qualitative data

The findings are based on qualitative data so the report avoids the use of quantifying language (including terms such as 'most' or 'a few') as far as possible, since the purpose of qualitative data is to identify the range of views and experiences on an issue, rather than to estimate prevalence.