Disability assistance in Scotland: analysis of consultation responses

5 Disability Assistance for Working Age People (DAWAP)

5.1 Benefit Rules: Activities and Descriptors

The Scottish Government is proposing that the criteria for awarding DAWAP will be determined on a ‘points-based’ test against a list of daily living and mobility activities. Each activity will have a list of descriptors, describing different levels of need in undertaking each of the activities and points will be awarded on the descriptor that best meets the needs described by an individual. Questions 50 and 51 asked:

Question 50: Do you agree or disagree with our proposal to use a points-based system to assess eligibility in relation to Disability Assistance for Working-Age People?

Question 51: If you disagreed, please could you explain why.

As shown in the following table, almost half of all respondents agreed with this proposal to assess eligibility, with only one in five disagreeing:

Table 26: Q50

	Number
	Agree	Disagree	Don’t know	No response
Campaigning / Advocacy (13)	1	4	2	6
Local authority (14)	7	2	2	3
Third sector (40)	13	6	4	17
Other (7)	2	1	-	4
Total organisations (74)	23	13	8	30
Individuals (189)	102	45	26	15
Total respondents (263)	125	58	34	45

A total of 94 respondents gave their opinions in response to Q51. The most commonly mentioned theme, cited by a third of respondents, was that a points-based system lacks flexibility to determine levels of disability or the fulfilment of entitlement criteria and is thus unfair. An issue specific to this topic was that a points system cannot give consideration for conditions which have day-to-day fluctuations in abilities.

Significant numbers of respondents perceived that points systems have been discredited and do not work. Comments around this theme included:

• All people are different or every case is different.
• People are not ‘tick boxes’.
• A one size fits all process doesn’t work.

"I’ve yet to see a points-based system I agree with and that actually works.

A points based system doesn’t have a person-centred approach, it’s just a way of gathering metrics. The points-based system is all well and good, however, some folk can have good days and bad. Some may be able to walk x amount of distance because of no other option (no family or carers to help) but then suffer later. The conditions need understanding and how this affects the person and family and lifestyle."
(Third sector organisation)

Other negative comments, drawing attention to problems with a points-based system, were made by significant numbers of respondents and included the following:

• The points system is too binary or black and white in nature (for example it is possible to score either 8 points or zero for a descriptor, but without an option in between).
• Negative experiences of the PIP points-based assessment system, including lack of consideration of whether an individual can complete an activity safely, inaccurate application of individuals’ experience and evidence against the descriptors, and high numbers of successful appeals against decisions.

Suggestions for alternative bases for an assessment system were made, each by significant numbers of respondents, and included the following:

• The system should be based on the input of professionals taking part in care (e.g. general practitioners, consultants, social workers) and not just one assessor or decision-maker.
• The system should include a qualified or trained assessor’s input, assuming they have the appropriate expertise.
• The system needs a more person-centred approach, and not just a medicalised understanding of disability.
• A system alternative should be based on medical evidence rather than points.

Additionally, a preference for the previous Disability Living Allowance rules for adults, based on frequency of assistance day and night, was expressed by a few respondents.

A few respondents said they were generally in favour of a points-based system. Other small numbers of respondents suggested tweaks and alterations to any (existing) points based system. These included the following:

• Clarity on how to apply a points system using the assessment method.
• Revising the descriptors to increase fairness (e.g. abolishing the 50% rule that is applied to descriptors).
• Allowing an element of interpretation or discretion to be used.
• Taking adequate account of the impact of mental health issues on individuals.
• Having the same points system makes sense during any transition phase, as long as changes are made in the longer term to ensure the same or greater rights as individuals are entitled to under the UK system.

Question 52 then went on to ask:

Question 52: Do you have any suggestions about the most appropriate way to assess eligibility in relation to mobility for Disability Assistance for Working-Age People?

A total of 185 respondents provided suggestions.

Large numbers of respondents chose to focus on the sources of evidence they thought should be used to assess eligibility. The greatest number (one in four respondents making a response) recommended the use of medical consultants, experts, and specialists and their reports and evidence. Types of specialists mentioned included occupational therapists and physiotherapists. Small numbers of respondents cited the use of medical reports and evidence without specifying sources.

Additionally, significant numbers of respondents recommended the use of reports, other medical evidence or mobility assessments produced by the patient’s own general practitioner. Smaller numbers also suggested using the evidence of peoples’ families, carers and other personal contacts, or social workers’ assessments and other evidence.

A broader theme, raised by nearly one in four respondents answering the question, was agreement that the assessment process needs to be person-centred in terms of paying more attention to the person’s own evidence, circumstances and needs in terms of transport and movement.

"Assessment of mobility needs should be person-centred and based on:

• the client’s account of how their condition affects their ability to get around safely including the risks to which they are exposed when getting around as a result of their condition; and
• a good understanding of the condition in question."

(Third sector organisation)

Significant numbers of respondents (and notably one in four responding organisations) thought assessors themselves needed to improve in the following ways:

• Requiring specialist or medical experience.
• Needing a better understanding of disability conditions.
• Considering all the evidence, not just that gathered on assessment day.
• Not just considering use or non-use of disability equipment.

Large numbers of respondents chose to focus on various criteria that they considered were under-accounted for in assessing eligibility in relation to mobility for DAWAP. There were a significant number of respondents who commented that more account should be taken of mental health or mental illness, particularly in terms of its effects on physical health. Examples of conditions considered in this context were psychosis, paranoia, depression, allodynia and anxiety issues. Suggestions made to help incorporate these conditions into assessments for eligibility included giving sufferers extra support or counselling, producing paper-based reports to reduce face-to-face stress and taking into account the physical side effects of medication used by those with mental health or illness problems.

"Even following the reversal of the 2017 changes to the PIP regulations, only two descriptors (Planning and following journeys (b) and (e)) used to assess mobility have clear relevance to mental health. In both instances these refer to psychological distress to people in regards to making "any journey". We believe this is overly restrictive and does not cover the full circumstances where someone’s mental health may impact their mobility. For example, this may be due to the side effects of medication. New mobility descriptors should be co-produced with people with mental health problems as well as expert stakeholders."
(Third sector organisation)

A similarly high proportion stated that more account needs to be taken of fluctuating conditions. Examples of these were noted including Multiple Sclerosis, Lupus and Ehlers-Danlos Syndrome. Suggestions for incorporating these conditions more effectively included taking an average day as the analysis point or considering symptoms on a ‘worst’ day rather than ‘best’ day.

A wide variety of other criteria considered under-accounted for in assessments were cited by smaller but still significant numbers of respondents, and these included the following:

• A greater number of ‘hidden’ disabilities or health conditions than allowed for currently (e.g. Dyspraxia, Myalgic Encephalomyelitis, Epilepsy).
• Presence of fatigue-related conditions (e.g. Fibromyalgia), including the amount of effort undertaken to do an activity or recovery time required.
• The impact of pain in undertaking mobility tasks (whether or not successfully completed).
• Learning difficulties (e.g. Autism, Down’s syndrome, neurological health conditions, anxiety and sensory impacts), including understanding things like distance, measurements, and navigation.
• Ability or inability to use public transport or plan journeys.
• Chronic or degenerative conditions (i.e. conditions which will not get better).
• Place lived or housing location (e.g. whether urban or rural, road status for disability access, hilliness).

Significant numbers of respondents commented on the rules and tools used to compile the points assessment system. Most frequently mentioned (including by one in three responding organisations) was agreement that the 20 metre threshold for qualifying for the enhanced rate of the mobility component is problematic. Reasons given were that it is too limited a distance to be of use, that it was designed to reduce peoples’ benefits or prevent them leading a full quality of life, or that it was better to return to the "virtually unable to walk" test which was used to establish entitlement to the higher rate of the mobility component for Disability Living Allowance. Similar numbers of respondents wanted to see the ‘distance moved’ rule to be scrapped entirely on the grounds that it is too simplistic or arbitrary and doesn’t account for things encountered in everyday life such as navigating furniture.

"The adoption of the 20 metre rule has had an impact on disabled people's ability to work, participate in family and community life and increased costs and social isolation. In addition though a blind person might be able to physically walk 20 metres their ability to do so safely without putting themselves and others at risk is minimal."
(Third sector organisation)

A focus on whether everyday activities can be undertaken, in line with current requirements, safely, reliably and repeatedly without risk of harm was suggested as an assessment tool by significant numbers of respondents (including one in four organisations). Similar numbers made a point about needing clarity over how to account for usage of walking aids or travel enablement requirements (such as wheelchairs or vehicle adaptations) in assessment criteria. Finally, there were a few mentions of needing a change in descriptors or how eligibility is assessed generally in order to encourage independent living.

Question 53 went on to ask:

Question 53: Do you have any comments on the full list of descriptors currently used to assess claims for Personal Independence Payments?

A total of 116 respondents gave an answer. A large majority of comments were general in nature, applying to the descriptors as a whole rather than individual descriptors, with only a small minority (less than one in ten) making general positive comments couched mostly in terms of them being clear, mostly fair or a good starting point for assessment.

There were two themes mentioned most frequently (each by over one in four of those replying to the question). Firstly, that the descriptors do not make sufficient allowance for, or are not relevant to, those clients with mental health conditions or are geared towards those with physical disabilities only. A variety of mental health conditions were put forward as affecting physical ability as follows:

• Psychological health conditions.
• Neurological disorders.
• Depression.
• Schizophrenia.
• Bipolar disorder.

As two organisations put it:

"We are also concerned that for each descriptor the only mental health consideration taken into account is "a lack of motivation" which does not appropriately describe the nature of mental health problems and their broader impact on a person’s daily living. …They need to realise that cognitive impairment is just as disabling in many ways as physical."
(Third Sector Organisation)

"…the only descriptor that is used to apply to those with mental health conditions is the "requires prompting to carry out this task". This descriptor only carries two points which means that no matter the significance of the condition, an individual with a mental health condition can only ever score 2 points in the majority of the activities."
(Campaigning / Advocacy Organisation)

Secondly, a general theme was made about the descriptors needing to be altered so they more properly reflect the impact of disabilities on daily lives as opposed to functional ability. Respondents cited a desire to empower people or make them focus on what they are able to do rather than the negatives associated with disability.

"The current descriptors tend to focus on negatives - what a person cannot do - rather on what a person could do with the right support. Disabled People have told us that this focus on the negative can impact on wellbeing and mental health."
(Third Sector Organisation)

Other themes, all cited by significant numbers of respondents, focused on other factors perceived as not being taken into account sufficiently by the descriptors. These included the flowing:

• Descriptors not encompassing or making allowances for fluctuating conditions (e.g. Multiple Sclerosis, Epilepsy).
• Descriptors not making allowance for those with learning disabilities or memory issues.
• Descriptors not taking levels of fatigue or exhaustion encountered while doing activities into account.
• Descriptors not taking pain levels into account.
• Descriptors need to be changed to account for specific conditions (e.g. Visual disability, Epilepsy).
• Descriptor points not adequately catering for the amount of care or supervision required (e.g. for night time care).

Several examples were given by respondents including the following:

"…we have been working with one person with vision impairment who accesses our services who was registered as partially sighted … following a brain injury and has not worked for ten years, but nevertheless his application for PIP was not successful. This decision is currently being appealed. He received no points against the descriptors used for his assessment because their application completely failed to recognise properly his daily living needs. Because he said he was able to prepare a bowl of cereal for himself, this was assessed as his being ‘able to prepare and cook a simple meal unaided’ – despite the fact that when he had attempted to cook a meal on another occasion items in the kitchen were burned presenting a fire risk. The assessment of his functioning vision failed to take account of the fact that his neurological vision impairment causes him to hallucinate. His problems dressing were not taken account of, nor did he receive any points on mobility despite the fact he requires a cane to negotiate any journeys. …We believe it is extraordinary that someone living with this level of vision impairment would receive no points after an assessment, but this is not an isolated case as we have highlighted." (Other organisation)

General negative comments about the nature of the descriptors were also made by significant numbers of respondents as follows:

• They are too vague or generalised, such that they cannot be applied to all medical conditions or situations.
• They are confusing or difficult to understand.
• They are designed to make people fail eligibility.
• They are too prescriptive or inflexible and do not allow for discretion.

Small numbers of respondents cited a need for any changes to the descriptors to be evidence-based, following, for example, a consultation with users and relevant organisations.

A very small number of respondents foresaw a need for automatic entitlement being available for those with severe, chronic, or terminal illnesses (e.g. if supported by available evidence).

Small numbers of comments were made specifically about the mobility descriptors; the largest number agreed that the 20 metre threshold is problematic because it is regarded as:

• Inaccurate as it fails to encapsulate mobility needs; and
• Punitive as it excludes clients from financial support thereby affecting their quality of life.

5.2 Face-to-Face Assessments

5.2.1 Informal Observations

The consultation paper noted that during assessments, assessors are permitted to make informal observations about the individuals they are assessing, and respondents were asked:

Question 54: What types of observations, as part of a face-to-face assessment, do you believe are inappropriate?

Comments were made by the majority of respondents, 184 in total. Many different types of observation were cited as inappropriate by significant numbers of respondents, while about one in seven said that all or almost all observations are inappropriate.

"The key underpinning purpose of a face-to-face assessment should be the intention to support individuals to tell their stories so that assessors can make accurate, robust decisions. It is critical that this is also how the individual being assessed perceives the process.

… all types of observation undermine this approach as, by their very nature, they are opaque and lack clarity about what is being ‘observed’ and ‘why’. They create an adversarial relationship and an atmosphere of distrust, in which there is an expectation that the agency is trying to ‘catch you out’. Furthermore, they undermine the credibility of people’s lived experiences. Individuals claiming Disability Assistance are experts in their own lives and should expect to be believed and trusted." (Campaigning / advocacy organisation)

Furthermore, similar numbers regarded face-to-face assessments generally as inappropriate, with many saying medical evidence or reports should be key to decision-making.

Among those specifying particular types of informal observation as inappropriate, the greatest number (one in four of those respondents answering the question and two in five answering organisations) cited observations relating to personal appearance (or appearance of the home if a home assessment). Consultees referred to a well-dressed, clean or well-nourished appearance as resulting in harsh judgments as to eligibility for support.

"'Client well kempt and wearing clean clothes'. Surely this is a default condition and not worth commenting on? The converse i.e. scruffy and dirty, is in contrast worth commenting on as it may indicate self-neglect." (Local authority)

A number of other informal observation types considered to be inappropriate were also stated by significant numbers of respondents, as follows:

• Movement, strength and sight tests (if unsafe or painful).
• Behavioural observations (e.g. mood or demeanour, body language or ability to engage with the assessor).
• Judgemental observations or assumptions made by the assessor (i.e. observations unsupported by any other evidence).
• Informal observations inappropriate to certain conditions or disabilities (e.g. autism, Asperger’s syndrome, memory problems, mental health, brain injuries, depression, neurological issues, hearing loss).
• Observations about how the individual travelled to or arrived at the assessment appointment (e.g. with or without an aid).
• Observations where medical evidence already exists to back up the effects of the condition (or only have observations where they are supported by medical evidence).

"Behavioural observations such as maintaining good eye contact, whether the individual is sweating, rocking back and forward or fidgeting are inappropriate, as are comments on appearance. The assumption that an individual must be rocking back and forward and dress unconventionally perpetuates the stereotype that individuals with a mental health condition must look and act a certain way. We also often see reports that claim that the individual does not have an anxiety disorder as they were able to sit still and engage with the assessor despite the ability to sit still not being a basis for diagnosis of anxiety. How an individual behaves in an official face-to-face assessment where there are established societal rules for engagement can in no way be taken as an indicator of how they behave in social circumstances." (Campaigning / advocacy organisation)

Smaller numbers of respondents also cited demographic observations (e.g. about race, gender, age), physical examinations and questioning or observations that may cause distress (e.g. about suicide or end of life care) as being inappropriate forms of informal observation. Observations taken while the client is in the waiting room or waiting for their appointment time were also regarded as inappropriate by a small minority of respondents.

Significant numbers of respondents made comments about how they perceived assessments should be conducted. The largest proportions focused on two areas: firstly, that face-to-face assessments need to be done by trained or experienced assessors with a good understanding of the condition or conditions of the people being assessed; and secondly, as per the Scottish Government proposal, that informal observations need to be discussed openly at the time to be transparent.

"A particular issue with current PIP face-to-face assessments is that observations made by assessors are included in the assessment report without the client having any opportunity to explain them. This can result in the observations being made being an inaccurate reflection of the impact of a person’s condition on their daily living and mobility, and ultimately be a source of inaccurate decisions being made on eligibility." (Third sector organisation)

Other comments relating to perceived problems with the assessment process were made, again by a significant number of respondents. These issues included the following:

• Detrimental assessments caused by clients masking or underplaying their conditions.
• A need to ensure that questions in relation to the assessment process are clear and easy to understand.
• Fluctuating conditions causing unrealistic assessments based on only a snapshot of the day.

Finally, a very small number of respondents (one in twenty-five of those responding) considered that all observations are appropriate within the context of the assessment.

5.2.2 More Choice when a face-to-face assessment is required

The Scottish Government are proposing that individuals are provided with choice and flexibility, taking into account the distances people are expected to travel and their location preferences, when they are invited to an assessment. Question 55 asked:

Question 55: In relation to assessments, what are your views on acceptable distances to travel?

A total of 204 consultees responded to Q55. Around two in five of these suggested maximum acceptable distances or times to travel to assessments, while the vast majority of respondents (including those suggesting times and distances) cited provisos or problems with travel.

Among consultees who suggested maximum acceptable distances to travel, there was little consensus, with respondents citing distances ranging from less than 5 miles up to 30 miles in fairly equal measures. However, all but one consultee who gave a maximum acceptable time of travel stated times of between half an hour and one hour, these times being given by equal numbers of respondents. Table 27 provides a breakdown of acceptable distances and times outlined by respondents.

Table 27: Q55

	Number
	Total	Organisations	Individuals
< 5 miles	7	1	6
5 miles	10	1	9
5.1 – 10 miles	12	2	10
10.1 – 20 miles	10	1	9
20.1 – 30 miles	7	2	5
Total respondents (distance given)	46	7	39
½ hour	17	3	14
1 hour	18	9	9
1 & ½ hours	1	-	1
Total respondents (time given)	36	12	24

Among the comments received, one in three respondents were of the opinion that assessments had to be local to the client, in terms of being within their local area, town or city. Various venues were suggested to help enable local assessments as follows:

• GP surgeries.
• Council offices (with disabled access).
• Health centres.
• Libraries.
• Hospitals.
• Social Security Scotland Offices.
• Community Halls.

One in three of those responding (including more than one in two organisations) made a point that the ability to travel depended on the particular condition or disability or health status of the client at the time of assessment, with the implication that decisions on distance to be travelled should be taken on a case-by-case basis.

Significant numbers of respondents cited other problems with travel to assessments:

• Travel for many is dependent on transport availability or accessibility (e.g. public transport, having own transport, having someone available to help, taxi availability).
• The Highlands and Islands and other rural areas have particular problems with distances and transport availability.
• Distance travelled is not the main issue - often it is the amount of effort and stress incurred in travelling to assessments which is the problem.
• Unaffordable travel costs, with requests that these should be limited, subsidised or reimbursed.

Significant numbers of respondents stated that assessments should preferably be at home depending on the client’s condition, while small numbers of individual respondents said their assessments would have to be at home as they were incapable of travel or totally housebound. Small numbers of respondents suggested that flexibility to enable attendance is essential, or that there needs to be an option for an individual to choose a venue that meets their access and travel needs.

Question 56 then went on to ask:

Question 56: What other circumstances should the Agency take into account?

A total of 171 respondents gave a response to Q56. A wide variety of other circumstances surrounding travel and ability to attend assessments were suggested. The most frequently mentioned of these was whether a carer or other support is required to help with travel, cited by one in four respondents. Various potential difficulties were mentioned including carer availability and responsibilities and the amount of support needed.

"It is not just about the distance to an assessment centre, Is there disabled parking? Is there a bus stop nearby? How far will someone have to walk to get to the centre? Once there does the centre have disabled access? Does it have a lift within it? All these factors can contribute to the stress and anxiety of travelling for an assessment."
(Third sector organisation)

Other circumstances to be considered were raised by smaller, but still significant numbers of respondents as follows:

• Accessibility and / or the environment of the place of assessment (e.g. reduced visual acuity, wheelchair access, noise levels, temperatures, toilet arrangements, pavement maintenance, parking availability, hearing loop).
• Appointment timings needing more flexibility (e.g. early mornings are very difficult for those with certain conditions and there is a need to take account of the time required to get ready, bearing in mind pain management or medication times).
• Home visits being needed where there is an inability to attend.
• Help and support availability for travel for those in rural areas or remote locations.
• Costs and affordability of travel to assessments.

Significant numbers of respondents agreed with the consultation paper that a person-centred approach was required, given that everyone has different circumstances (e.g. multiple conditions).

Significant numbers of consultees chose to specify various conditions for which they thought there should be no or very few face-to-face assessments undertaken, given their nature or the difficulties faced by sufferers in doing so. These included:

• Autism.
• Asperger’s.
• Global developmental delay.
• Sensory processing disorder.
• Attention Deficit Hyperactivity Disorder.
• Some mental illnesses resulting in difficulties processing questions or articulating answers.
• Degenerative and chronic conditions.
• Terminal illness^[3].

The consultation went on to explain that for efficiency reasons there will have to be a limit to the number of assessment appointments that individuals can cancel or fail to attend. Question 57 asked:

Question 57. In relation to assessments, how many times to do you think an individual should be able to reschedule, or fail to attend, an appointment?

A total of 205 respondents responded to this question. The majority (approximately three quarters of respondents) expressed an explicit number of times an assessment can be rescheduled, but these were often caveated with reference to exceptional circumstances that may mean an individual has to cancel several appointments.

More than two in five cited three occasions, out of all those giving a number. More than one in four cited two times. However, nearly one in five respondents (particularly third sector and campaigning / advocacy organisations) thought rescheduling should have no limits.

Table 28: Q57

	Number
	Total	Organisations	Individuals
Once	8	-	8
Twice	37	5	32
2 /3 times	9	3	6
Three times	59	9	50
More than 3 times	5	-	5
No limit / as many times as needed	24	9	15
Total respondents	142	26	116

A total of 94 respondents gave their opinions in response to this question, and two in five said that rescheduling should depend on the reasons for cancelling, and nearly one in four that it should depend on the particular individual which echoed the need for a person-centred approach.

Smaller but still significant proportions of respondents cited the following caveats for deciding whether an assessment can be rescheduled:

• It should depend on the client’s illness / disability / condition.
• There is a need for flexibility and choice when making or rescheduling appointments (taking into account factors such as support availability or lengthy notice being required).
• Repeated failure to attend should result in a home appointment or telephone or paper review or some other alternative solution.
• If many appointments are missed a good reason needs to be provided (e.g. sick note or letter of support from client’s GP or health team).

Further to missed assessments, respondents were asked:

Question 58. In relation to a missed assessment, do you have any comments on what should amount to exceptional circumstances (e.g. hospital admissions)?

A total of 187 respondents made comments or suggestions as to situations which should amount to exceptional circumstances in relation to missed assessments. The highest proportion (nearly half) repeated the suggestion in the question, i.e. hospital admissions. Almost as many cited client illness as an exceptional circumstance, particularly if related to flare ups of the client’s disability (e.g. epileptic fits, seizures, asthma, pain).

High proportions (nearly one in three respondents) mentioned bereavement as an exceptional circumstance, in many cases specifying family bereavement; there were also a few mentions of funerals.

One in five respondents affirmed carer or support availability issues; reference was mainly made of cases where the carer of the client was unavailable, but mention was also made of instances where the client has carer responsibilities. Childcare unavailability issues were also mentioned in relation to this theme.

Other medical issues were referred to by smaller but still significant numbers of respondents, including:

• Hospital appointments (because of rescheduling difficulties).
• Other medical appointments such as for doctors, dentists or psychiatrists.
• Illness in the client’s family (e.g. children, dependents).
• Stress or anxiety, in cases where mental health conditions are involved (e.g. Meniere’s attacks, schizophrenic episodes, autism, Attention Deficit Hyperactivity Disorder).
• Physical incapacity or severe mobility restrictions.
• Inability to open, read or remember the appointment letter (because of memory loss or lack of capacity).

A significant number of respondents mentioned transport issues on the day, including transport cancellations, breakdowns or other transport disruptions. Small numbers of respondents pinpointed adverse weather conditions affecting travel (e.g. snow or ice); a few respondents also mentioned an inability to pay for travel.

Other circumstances, as cited by smaller numbers of respondents, included the following:

• Emergencies generally (e.g. accidents).
• Work commitments.
• Other family-related occasions (e.g. graduations, weddings, holidays, house moves, once in a lifetime events).
• Court attendance or jury duty.

Significant numbers of respondents also cited general caveats about situations which might amount to exceptional circumstances. In particular, nearly one in five of those respondents answering the question said that missed assessments need to be looked at on a case-by-case basis:

"…we think that the key question should be what impairments/health conditions does this person have and how might that impact on their ability to attend an assessment on a particular day. This is a more holistic approach and gives the person making a determination on non-attendance more discretion as to whether it was reasonable for the person claiming the benefit not to have attended the assessment as scheduled." (Third Sector organisation)

Additionally, small numbers of respondents stated that the circumstances surrounding a missed assessment should depend on the nature of the client’s illness, condition or disability, while others maintained that there was a need to show proof of the circumstances (e.g. written confirmation by the client’s GP or hospital).

5.2.3 Face-to-face Assessments will be Audio Recorded as Standard

The consultation paper explained that the Scottish Government is committed to introducing the audio recording of assessments as standard. Question 59 asked:

Question 59. Please provide any comments you wish to make about the audio recording of assessments.

A total of 168 respondents gave their thoughts on the introduction of standard audio recording of assessments. A large majority of comments were positive in nature; nearly two in five respondents welcomed the idea in general, and one in five reinforced that recording should be carried out as standard or made compulsory.

Significant numbers of respondents specified areas in which they perceived that audio recordings would be a positive step forward. Chief amongst these themes were that: audio recordings will help to resolve areas of contention as they will give an accurate account of proceedings; and audio recordings will help assessments be fair and transparent and so will help safeguard both clients and Social Security Scotland staff.

Small numbers of respondents also perceived that audio recordings will be useful if an appeal is required, or to help build trust in the system.

"Frontline advisers suggest this would be a welcome step in ensuring transparency of the assessment. All advice agencies … regularly report clients telling advisers what they said during their assessment is not what is reported by the assessor. Therefore an audio recording would safeguard all involved and should contribute to a reduction in the need for appeals when an adverse decision has been received and the challenge relates to ‘false’ evidence contained within the report."
(Local Authority)

However, significant numbers of respondents, although broadly positive in their remarks about audio recordings, made caveats about audio recording of assessments. The most frequently mentioned of these, cited by one in five respondents (including half of responding organisations) who answered the question, was that the recordings should only be made with the client’s consent or that clients should have the right of refusal. Additionally, small numbers of consultees said the recordings should only be made as long as all parties consented.

Further provisos, each made by a significant number of respondents, stated that recordings should be made:

• As long as they are made available to the client (either just after the assessment or with the decision letter).
• As long as they are made available to the client (not specified whether at the tribunal stage or another time).
• As long as they are made available to all involved.
• As long as all parties are informed beforehand (about the purpose of the recording).
• As long as there are strict rules in place (e.g. about retention, use, security, data management, confidentiality and destruction).
• In line with GDPR requirements.

Around one in ten of the 166 respondents answering the question stated a preference for a video recording to be made, either as well as or instead of an audio recording, in order for example to see how individuals present themselves or to capture non-verbal communication.

"In addition, the Scottish Government should give consideration to whether video recording of assessments would further enhance trust and transparency in the process. This would be particularly important if an assessor was permitted to make informal observations. The Department for Work and Pensions previously announced plans to pilot video recording of PIP assessments with a view to making it a standard part of the assessment process across Great Britain."
(Campaigning / advocacy organisation)

A small number of respondents foresaw a need to make allowances for deaf people, suggesting the provision of transcripts or a British Sign Language DVD.

There were a small number of comments suggesting types of acceptable recording devices: digital equipment, MP3 format equipment, CD’s and USB drives were recommended. A few respondents stated that clients should be allowed to make their own recordings.

Only small numbers of respondents were negative about audio recording of assessments. The main concern was that recording may cause clients to be uncomfortable or anxious, particularly if they suffer from mental health problems; a few mentions were made questioning their necessity, claiming that all relevant information should be available anyway, or citing their invasiveness as an evidence-gathering method.