Social Security Experience Panels: award duration and automatic entitlement

Light Touch Reviews

A light touch review is a potential alternative to a reassessment. Light touch reviews differ from face-to-face health assessments in a number of ways. The reviews would primarily be paper-based, however sometimes clients may need to attend a face-to-face review. Client's benefits would continue to be paid throughout the review period at the same rate as before. The review would be designed to be as easy and stress-free as possible for the client.

What evidence should be used

In order to minimise the amount of evidence that participants have to gather for assessments or reviews, one potential future option is for Social Security Scotland to use evidence from past DWP health assessments as part of the light touch review. This could include the report produced by the health assessor.

These health assessments were carried out by a health professional appointed by the Department for Work and Pensions, typically as part of a PIP application. We know from previous research^[5] that many Experience Panel members feel strongly about the accuracy of these reports therefore we wanted to understand their thoughts on this suggestion.

Thirty-nine percent of survey participants wanted previous evidence from DWP assessments to be used by Social Security Scotland. Just over one in five participants did not (22 per cent) and just under a third wanted the choice (30 per cent). Ten per cent of participants were unsure.

Table 11: Should evidence from DWP health assessments be used by Social Security Scotland when making a benefit decision? (n=241)

Response	%
Yes, evidence from previous DWP assessments should be used by Social Security Scotland	39
No, evidence from previous DWP assessments should not be used by Social Security Scotland	22
I would like to choose	30
Don't know / not sure	10
Total	101

Excluding participants who chose 'I would like to choose' and 'Don't know', just over two thirds (64 per cent) wanted previous DWP evidence to be used by Social Security Scotland (35 per cent did not).

In focus groups, participants talked about not trusting the reports produced as part of their previous health assessment, believing them to be inaccurate or incomplete.

Many participants commented that their previous health assessment had been a highly negative experience and that using previous evidence from DWP did not align with the concept of a fresh start for the new agency:

"The reason for this survey is to improve the system. Looking at previous claims won't always work at this stage as at my last assessment the nurse put lies on the decision. Things that were not true and had a devastating affect [sic] on my claim and mental wellbeing."
- Survey participant

Other participants raised concerns about the information in the health assessments being out of date or incomplete.

Some were happy for the previous health assessment evidence to be used – these were usually participants who had a positive experience with their assessor or had seen their reports and felt them to be accurate.

Participants were also asked what other sources of evidence Social Security Scotland should use in deciding whether to make an award. A range of sources were offered including health professionals, schools and social workers or carers. Participants across all focus groups and in the survey consistently stated evidence provided by GPs or consultants who directly knew the claimant should be trusted.

What should light touch reviews be like

Participants were mostly positive about having a light touch review instead of a reassessment, however there were some differences in their views on what the review should be like.

Some participants wanted as little communication as possible through the review process, only being contacted when necessary as needless letters caused more stress. Many participants spoke of the "dreaded brown envelope" from the Department for Work and Pensions arriving, with some being too stressed or anxious to open the letter. They believed streamlining the process, with Social Security Scotland doing as much work as possible without having to contact the client, would minimise this stress and the client's workload. Other participants disagreed, and would prefer more regular updates (through email or post) on the status of the review.

If the client had to be brought in to a Social Security Scotland office as part of the review, participants emphasised the importance of not asking a generic set of questions to everyone and instead tailoring the assessment to people's individual circumstances. Most participants who had undergone a health assessment could recall being asked generalised questions that were inappropriate or insensitive to their condition. These types of questions made participants feel that their assessor had a poor understanding of their condition.

Participants across focus groups and the survey made a large number of specific suggestions as to what should happen during a review. Almost all of these suggestions related to the review being face to face rather than paper based.

These suggestions can be summarised as:

• If a face-to-face review is necessary, clients should be made aware before the review that they are able to bring a representative, advocate or carer;
• Reviews should be scheduled at a convenient time for clients, with the option to reschedule as needed;
• The review should be carried out in a private space, in an easily accessible location;
• The review should take as long as necessary to allow the client to communicate how their condition affects them, without being overly arduous or excessively detailed; and
• Generalised sets of questions should be avoided where possible.

Who should carry out the light touch review?

Participants differed in their views in who should carry out the review. They suggested nurse practitioners and agency staff as potential options. Most participants felt that having a medical background was not strictly necessary – having a good understanding of disabilities and how they affect someones life was seen to be much more important.

Other important factors identified by participants included:

• Staff should speak plain English and not use jargon when communicating with clients during the review;
• Clients should be treated with dignity and respect by staff;
• Staff should be mindful that disabilities can affect clients in different ways;
• Staff should be patient, understanding and friendly to clients; and
• Staff should listen to clients.

Where should assessments and face-to-face light touch reviews take place?

Participants offered a range of suggestions (GP offices, health centres, town halls, etc.) however the main split was between those who would prefer them to be in a Social Security Scotland building and those who would prefer to have a choice of locations.

Participants who preferred a choice of locations typically viewed certain locations as being so stressful as to make them unable to attend. This was usually through past associations with DWP. As such, having a choice was a potential means of reducing or avoiding that stress. Others voiced concerns that having reviews in locations such as GP offices and health centres would remind them of the social security presence when they visited these buildings in the future.

Most focus group participants did seem to accept that the most likely outcome was for face-to-face light touch reviews to be carried out within an agency building and that so long as the building was accessible and easy to travel to, this could be acceptable.

Participants highlighted the need to offer home visits as an option, especially for clients who live in isolated areas or who have medical conditions that make travelling difficult.

Communicating light touch reviews

Communicating the difference between light touch reviews and reassessments was seen to be important in reducing client stress and giving them confidence that the light touch review process would be different to reassessments.

Participants had a number of suggestions as to how to do this: some suggested a leaflet could be included within the application pack and then again with future correspondence to make sure clients were aware and prepared for the review. Other participants wanted more extensive advertising of the process to ensure that everyone was aware that it was an alternative to a reassessment.

Participants emphasised the importance of giving enough notice of an impending light touch review. Many wanted to be informed of the month and year of their next light touch review upon being awarded the benefit, followed up by a reminder letter sent out six and then one month beforehand. Not everyone agreed with this, with some preferring a single reminder two months beforehand.