Devolved disability benefits evaluation: Special Rules for Terminal Illness (SRTI) - commissioned research report – annex A

Contact with Social Security Scotland

Contact between clinicians and Social Security Scotland

Across the sample, there was very little direct contact between clinicians and Social Security Scotland. Just over half of survey respondents said that they had been contacted directly by Social Security Scotland in the last 12 months for information required on a BASRiS. Just over half of these again indicated that they had either never followed up this contact by submitting a BASRiS form or had done so rarely.

Where clinicians had been contacted by Social Security Scotland with queries linked to the date of clinical judgement, some said they felt uneasy/perceived they were needing to defend their position. There was also some evidence among nurses in particular that they felt anxious knowing/confirming who they were speaking with when contacted by telephone by Social Security Scotland. Most clinicians said they would prefer email contact over telephone contact.

In more general terms, where contact with Social Security Scotland had been made by telephone, this was typically described in positive terms (i.e. staff had always been “professional”, “friendly” and “helpful”). Comments were made, however, that it could be difficult to get through to Social Security Scotland with generic queries.

A small number of clinicians (and support workers) mentioned that they would like to be informed by Social Security Scotland of the outcomes of applications where they had provided assistance, to support onward contact with the patient:

“Sometimes it would be nice to know, you know, like that the forms have been received - because it just goes and you’re just like, “Has it been received? Has anybody looked into it? How do we know?” Nobody’s contacted the family. The family are like, “What’s going on?” And then suddenly payments just appear.” (Nurse Specialist)

Similarly, a small number said that knowing the outcome would let them know if they were completing forms correctly and/or including too much or too little information (which would help them adjust/refine their approach to future forms).

Contact between clients and Social Security Scotland

Among clients and patients, where people had received help directly from Social Security Scotland in completing their applications (either at home, or via telephone/Teams) this had been very well received:

“I really appreciated it [help with the application from Social Security Scotland] because, otherwise, you know, sometimes if you fill in the forms wrong, it gets sent back and then you’re back and forth, back and forth. So, it was really helpful to have someone that helps people from Social Security. That’s what they do, they give people a hand to fill out these forms that are quite difficult.” (Client, Special Rules)

The main suggestion made by clients for improvements regarding contact with Social Security Scotland staff and information shared by them was to make clearer or more obvious the various supports that were available to help people with their applications, especially where literacy or other language barriers may exist:

“For them to obviously say that there is help out there for people that’s no good at filling out the forms - because there is people there like myself, you know, that struggles to read and write, you know, and understand the questions fully.” (Client, Unsuccessful Normal Rules Application)

Direct contact between clients and Social Security Scotland was most likely to be necessary in cases where applicants were experiencing delays or challenges with outstanding normal rules applications, typically where these had been made unsupported (with applications under special rules with assistance from a support worker usually resulting in a speedy and much more efficient response than individuals’ attempts to apply on their own).

Contact between support services and Social Security Scotland

Support workers tended to have more regular contact with Social Security Scotland in relation to queries for individual applications, or following up on earlier applications, with most telephone contact described in positive terms. The main issue again was waiting times to reach the right person in the agency to speak with.

As with clients, support workers noted that Social Security Scotland were very good at providing updates with regards to applications. Some also commented that this was markedly better than contact from DWP on the same issues:

“Scottish Social Security are good at writing out and telling people, “We’ve got your information, we’re going to be in touch” - their messaging’s very good at each step of the way. DWP side of it? I’m not sure how good they are at saying, “We’ve been updating this, therefore we’re passing things over.” From experience, I’ve seen better messaging from Scottish Social Security than I have from DWP on that one.” (Support Worker)

Suggestions for dedicated Special Rules contact routes

Across all respondent samples (clinicians, clients and support workers) there were suggestions for a dedicated Social Security Scotland telephone number or helpline specifically for special rules cases. All special rules applications (or normal rules applications identified after submission as special rules) are already handled by a dedicated team (as well as cases where a change of circumstances is reported by someone with a terminal illness diagnosis), however, this did not appear to be widely known. A dedicated team and/or phoneline was seen as justifiable both in terms of the sensitivity required by those handling special rules cases (i.e. Social Security Scotland staff with special training would be useful) as well as ensuring that when people did reach Social Security Scotland the person they spoke to was “the right person”. Several support workers also called for a dedicated escalation route for special rules cases, to support where there was a change in circumstances or where a query needed to be raised/addressed with urgency.

Key takeaways

While roughly half of clinicians had been contacted by Social Security Scotland in the preceding 12 months as a follow-up to provide more information on a BASRiS, only half of these again had followed up this contact by submitting a physical BASRiS form, with many instead noting that they provided BASRiS forms to other support organisations to assist with applications rather than submitting them directly to Social Security Scotland. While telephone contact was mentioned as the main contact route being used, the majority of clinicians expressed a preference for contact by email. While direct contact with Social Security Scotland was fairly minimal among clinicians and clients, where people had had contact, this was mainly described in positive terms. Clients in particular had welcomed the direct and person-centred support made available to them by Social Security Scotland staff when making applications. Support organisation staff generally had more direct contact with Social Security Scotland, and again feedback was mainly positive. Complications mainly occur for ‘non-standard’ cases where clients are unsure of their position (including where someone has already started or submitted a ‘normal rules’ application and/or if they are unsure of where their application is in the system and whether a new one should/should not be commenced) and applications for ‘new’ clients appear to be smoother and be processed more quickly in the main. The main areas where communication could be improved were linked to the perceived benefits of having a dedicated SRTI helpline and escalation route which was easily accessible to support workers, as well as the possible extension of the ‘allow list’ to include more support organisations. Overall, feedback in relation to contact with Social Security Scotland was positive, with many commenting unprompted that their experiences compared favourably to their contact with DWP, where they had experience of both.