Social Security Experience Panels: Personal Independence Payment health assessments

Recording health assessments

Within the current system as operated by the Department for Work and Pensions, clients have the option to audio record their health assessments. To do so, clients are required to adhere to rules set by DWP, including using an approved recording device, providing an identical copy of the recording to the health assessor on the day and giving permission for the health assessment organisation to keep a copy of the recording^[12]. Video recording is not allowed^[11].

In order to understand whether there was appetite for health assessments to be recorded in the future when the benefit was administered by Social Security Scotland, respondents were asked their preference.

Almost three quarters of respondents said they would like their assessment recorded (72 per cent) with almost a quarter saying 'Maybe' (23 per cent). One in twenty responded negatively (2 per cent), or that they had no opinion (3 per cent).

Table 13: Would you like your health assessment to be recorded? (n=128)

Response	%
Yes	72
Maybe, it depends	23
No	2
No opinion / don't know	3
Total	100

Why do respondents want health assessments recorded?

Respondents gave varying reasons for why they would like their assessment recorded.

The most common reason was the desire to create a verifiable record of the health assessment itself that could, if required, be used to verify what the client or the health assessor said.

Many respondents wanted this as they did not trust the health assessor as a result of their past experiences.

"The reports completed in my assessments were inaccurate and if the assessment had been recorded it would have been clear that was the case…"

"[I] have experienced an assessment where the nurse lied about me carrying out certain movements that did not actually happen, i.e. she made most of it up. Recording would protect the claimant and the medical professional."

""When I appealed my mobility decision, I was made to feel like a liar as I accused the assessor of lying on my form. A recorded interview or assessment would validate what both parties are saying…"

Others did not trust the health assessment companies, and felt they did not honestly report the results of their health assessment.

Some respondents felt that recording the assessment would 'improve' the quality of the reports, 'give them redress' should they choose to appeal and ensure the assessor treated them fairly.

A small number of respondents said their particular health condition impacted on their memory, and that having a record would help them personally remember what happened:

"I can't remember details due to ptsd. If asked questions later, I could refer back to the recording…"

Finally, respondents who had wanted - but been unable to - record their assessments in the past felt that a policy of recording all assessments should be fair, especially for people who could not provide the equipment required under the current policy.

"I had to spend £150 on equipment so I could record the assessments afer the health care profesional lied on the form at my first assessment."

"The hurdles put in place regarding recording assessments is outrageous. People should be entitled to have their assessment recorded if they wish."

Why do respondents not want their health assessment recorded

Respondents who said they did not want their health assessment recorded were in the minority, however they gave several reasons as to why they felt this way.

Some respondents had concerns around the privacy, or the protection of sensitive personal data:

"Not sure about recording as this seems a step too far in "big brother" type of attitude…"

"I mistrust the current assessment process and would not like intimate details of how my condition affects me to be at potential risk of inappropriate viewings."

Others were worried about what the data would be used for, or would find being recorded stressful:

"…part of me worries that in the hands of an unscrupulous government it might be viewed by body language specialists to decide the outcome of the claim."

One respondent said that if health assessments were recorded by default, they would feel like they could not attend as it would cause them 'great distress'. Ensuring clients are aware in advance that recording is optional may reassure such clients.

How should health assessments be recorded

Respondents who said they would, or would maybe like their assessment recorded were asked whether it should be an audio or video recording. Most respondents preferred an audio recording (56 per cent) however just under half would also be happy with video (44 per cent).

Table 14: Respondent recording preference (n=112)

Response	%
Audio	56
Video	44
Total	100

Respondents who favoured audio recording felt that it was 'less intrusive' and 'less intimidating' than video recording. Some respondents said video recording was a 'scary prospect' and did not like the idea of being watched on film. Some felt that an audio recording would capture all of the needed information:

"An audio recording would capture the relevant information without being as uncomfortable as being filmed during an already traumatic experience."

Respondents who favoured video recording gave a range of reasons for this.

Many said that a video recording would present 'the whole picture' and result in 'absolutely no ambiguity in what was said or done during the assessment'. Some respondents felt that audio recording would miss out body language, which for them was important in showing how their condition impacted their lives.

"If I have a partial seizure during a conversation, sometimes it can be seen in a video but is not noticable if you don't know what to look for."

"Body language is also important. If a claimant is in pain or discomfort, or extremely anxious, it may be evident in the video recording."

Some respondents suggested a video recording would be most useful where a physical examination was conducted, to accurately show the client's response to requests made by the assessor. It was also felt to be more suitable in protecting the client should a physical examination take place.

Some respondents also hoped video recording would improve the quality of the assessment.

"…can be used to assess the assessor's interpersonal skills […] - so often they barely lift their head from the computer to address the claimant…"