Social Security Experience Panels - Adult Disability Payment: mobility component eligibility criteria

Cross-cutting comments

There were a number of points raised by participants and respondents that applied across all criteria or more generally to the decision-making process.

Consultations tailored to conditions

Many participants and respondents suggested that consultations need to be tailored to the particular conditions that an individual has. While changes by the Scottish Government committing to consultations being conducted by suitable health and social care practitioners were welcomed, a few participants noted that there still needs to be an awareness of how conditions and their effects vary between individuals.

"The fact that you're saying the assessments are going to be different, they're going to be by people who understand your medical condition, is a big plus for me. Because [if people don't understand my condition] then the questions that they ask just make you feel like – it makes you feel like you're trying to cheat the system. When, actually, you're trying to survive." (Interview participant)

"Assess each case on an individual basis - you cannot be too prescriptive." (Survey respondent)

Mental health

Many comments and suggestions related to mental health and how to best account for this within the consultation process.

Consider mental health conditions separately

Similar to comments made for the planning and following journeys criteria, some participants and respondents suggested that mental health needs to be considered separately from any mobility issues.

"What would be nice is if there was [a section] specifically covering mental health […] Take mental health out of the whole assessment process, and make it separate but in the same manner as what has been done [for the existing criteria]." (Interview participant)

As part of the follow-up survey respondents were asked if they agreed or disagreed with this suggestion to have a separate section covering mental health. The majority (58 per cent) agreed, however almost a fifth (18 per cent) disagreed and a quarter (25 per cent) neither agreed nor disagreed.

*Figures may not add to 100 per cent due to rounding.

Accurate recording of psychological or mental health conditions

Some participants and respondents commented that they felt there needed to be a full accounting of the psychological conditions that someone may face, citing past examples where they had not been properly recorded. This was seen as important for ensuring that an accurate report of any mental health conditions was formally recorded and acknowledged within the decision-making process.

"Mental ill health is a disability in its own right and psychological distress is simply not covered fully for the condition." (Survey respondent)

"The way it's set up just now, when I had my last PIP assessment they didnae give me any points for my psychological and emotional - the person just didn't hear me at all, they didn't take in what I was saying. I clearly explained that there can be weeks where I can't even go over front door or get out of bed and they still scored me zero for psychological side. So, it's like they thought 'Oh well he's got enough points on his physical so he doesn't need points for his psychological.'" (Interview participant)

Process inaccessible for those with poor mental health

Others commented that the application and decision-making processes are too difficult for people with mental health conditions, especially where they are unsupported.

"Anybody who has got an advocate with them, or somebody to help them, no problem. But you've got to remember that we've got a lot of people in the population who shut down. And they shut down on their bills, their forms – [the ADP application form is] too long for someone with a mental health condition." (Interview participant)

Medical history or supporting information

Gathering supporting information

Some participants and respondents suggested that the decision-making process should make better use of a person's medical history or the input of health professionals to determine how they are affected by a condition.

"See if somebody is unwell, they go to their doctors on a regular occurrence […] If someone's unwell, there will be a trace or a track of going to the doctor, taking medication, going to the hospitals." (Interview participant)

"The disability in above cases has been assessed/determined by a health professional, who takes all aspects of the persons condition(s) into account, including fluctuations, duration and prognosis. A care official is not qualified to make such assessments." (Survey respondent)

A few participants and respondents suggested that there may be cases where someone else is the best person to seek additional information from, such as close family or friends.

"Some consideration needs to be given as to who is the best person or people to get additional information from. Because my brother would not have the competence to answer any of those questions himself […] The reason that [my sister and I] went for guardianship just a few years ago is because decisions were being made by people who really did not know him well enough." (Interview participant)

Self-management of conditions

A few participants noted that it is important to be aware of when someone is self-managing their condition and rarely or never visits medical professionals, as this will reduce the supporting information that is available to them for applications.

Participant 1: "One of the biggest issues that we've raised over the years is that some people have a lack of proof [of a condition] or a lack of support in their lives […] You don't have proof, you don't have anything. You don't have consultants, you don't have GPs, because they do prescriptions for you but they don't get to see you ever. So you can't prove how it affects you, you can't prove anything […]"

Participant 2: "[That is] personal management of your condition."

Participant 1: "But again, how do you prove that? How do you justify that in an assessment or anything? Because I think that a lot of times the DWP ask when did you last see your GP? And I say, well I haven't seen my GP in two or three years now because I don't need to, but that doesn't mean I'm not unwell, that doesn't mean I don't have pain."

(Focus group discussion)

A few participants and respondents also suggested that there needs to be consideration given to any medication that a person has been prescribed and how this affects them, for example using pain medication to lessen the impact of a condition.

"[The people involved in making decisions need to look] at actual effects of medication that the person has described, they don't have to look at the side effects on every single label. But, if the person is describing a significant side effect, don't ignore it." (Interview participant)

Accessibility

As discussed in the mobility and fluctuating conditions sections above, some participants suggested that having examples would help applicants understand what the criteria were asking about. One participant suggested providing accessible versions of the form and supplementing text with images, supporting information and examples.

"Put it in big print for folk that are partially sighted, or in Braille for people who understand Braille […] put in pictures maybe, pictures of things, like a timetable, a train." (Interview participant)

Another participant suggested that for people who struggle with text-based responses, images or storyboards could be used to provide an alternative means of communicating about their condition.

"I just feel like, maybe it's just me, I don't like forms, but, you know, asking somebody to write a storyboard. Describe their average week or whatever just in a bullet-pointed storyboard, you know, would make far more sense than asking all these individual questions." (Interview participant)

Respondents were asked to comment on this suggestion as part of the follow-up survey. More respondents disagreed (42 per cent) than agreed (29 per cent), with almost a third (29 per cent) neither agreeing nor disagreeing.

*Figures may not add to 100 per cent due to rounding.