Devolved disability benefits: decision making evaluation

Findings

This chapter explores evidence from the data sources described in the methodology chapter to evaluate progress towards the short-, medium-, and long-term policy outcomes. Where there is overlap between different outcomes within the relevant section, these are discussed together.

Key Takeaways

This report aims to explore qualitatively how client experiences of the different policy areas underpinning decision-making can be used to evaluate the extent to which people’s experience of decision-making were in line with policy outcomes.

Through the evidence examined in the report, it becomes apparent that for the people who participated in this research, the policy cannot be separated completely from the experience of the operational side of decision-making, nor from the specific and personal circumstances of each individual. Clients often draw from operational and personal experiences to illustrate their experiences of the anticipated outcomes of the policy, and to illustrate the aspects of their experience that are most important to them. Relatedly, it should be kept in mind that the evidence presented throughout is based on people’s own understanding and interpretation of the policy and what that means for their unique experiences.

Overall, there is evidence that the policy principles of decisions being person-centred and trust-based are being met, however, client experience tended to vary depending on their circumstances.

Clients were more likely to feel that their experiences were in line with decision-making policy if:

• they had a successful application
• they had no decrease at review
• they had a scheduled review

Clients were less likely to feel that their experiences were in line with decision-making policy if:

• their application had been unsuccessful
• they did not agree with the award decision
• their award had been decreased after review
• they had an unscheduled review

The main themes that emerged from clients in relation to what led to decision-making feeling person-centred and trust-based were:

• feeling they were able to tell their story
• feeling heard
• feeling believed
• feeling trusted

Key mechanisms for the realisation of these themes were:

• decision letters
• contact, or opportunity to engage, with Social Security Scotland Staff

As above, separating client experience of decision-making policy specifically from other elements of their experience is complex, and therefore it is not possible from this research to ascertain whether all client experiences can be attributed to decision-making policy, or whether experiences are impacted by aspects such as:

• operational aspects
• individual circumstances and/or eligibility
• outcomes of applications/reviews

Progress towards the anticipated short-term outcomes

This section triangulates the evidence for each of the short-term outcomes from the logic model to gain an understanding of whether or not they have been achieved. It is important to note that in the commissioned research, the outcome of ‘individuals feel that their experience was person-centred’ generated the most evidence, with individuals tending to talk about whether their experience overall was appropriate for them as an individual. Generally, aside from the person-centred related aspects, there was less evidence for consultation and review-specific outcomes.

Do individuals feel that their experience was person-centred?

Overall, 64% of Client Satisfaction Survey 2024-25 respondents who applied for ADP or CDP agreed or strongly agreed that the application process enabled them to fully explain their/their child’s circumstances. Differences across respondent groups were as follows:

• 81% of CDP compared to 62% of ADP respondents agreed or strongly agreed.
• 80% of successful compared to 23% of unsuccessful respondents agreed or strongly agreed.
• 74% of ethnic minority compared to 64% of white respondents agreed or strongly agreed.
• 66% of women compared to 63% of men agreed or strongly agreed.
• 61-70% of those with all other conditions^[2] compared to 52% of those with social or behavioural conditions, excluding those with vision (54%) or hearing-related (58%) conditions^[3] agreed or strongly agreed.

Similarly, 62% agreed or strongly agreed that the application only asks relevant questions. For those who had communication with Social Security Scotland, 86% agreed or strongly agreed that staff had listened to them.

In line with survey findings, those in focus groups and interviews who were successful applicants or whose review award had increased or stayed the same were more likely (but not always) to feel that their experience was person-centred.

Some successful ADP, CDP and PADP applicants and review clients who had received either an increase or no change to their award felt that the supporting information they had supplied as part of their application or review was considered. They also felt that the decision accurately reflected the impact(s) of their health condition. They cited the decision letter for these beliefs, saying that the information in the letter about how the decision had been reached, suggested to them that this was the case. They felt listened to and trusted as a result.

“They took his needs into consideration and how he was as a person, his sleep processes, they took absolutely everything into consideration, so they did, everything about him.” (CDP scheduled review, award increased/stayed the same)

Furthermore, some clients expressed having a person-centred experience through receiving help with their application from Social Security Scotland or other organisations, citing positive interactions over the phone in which they felt that staff were empathetic and listened. They also felt that staff took the time to explain things and to understand the client's situation, without giving the impression that clients are viewed with suspicion. This made some clients feel supported, reassured, and treated as a human being.

“Anybody that ever phoned me to ask for additional information, they were very patient and very kind and very understanding, which I love.” (ADP applicant, successful)

“You felt that you weren't just one of 20 that was about to be dealt with that afternoon. You know, she was very happy to listen... she had patience... and I didn't feel that I'd annoyed her by taking a wee bit of time to remind myself where I put [the information].” (PADP applicant, successful)

Some were less likely to feel that their experience was person-centred. These were unsuccessful applicants and review clients who received a decrease in their award. They felt Social Security Scotland did not understand their situation or the impacts of their condition, which led to an award they did not feel reflected their situation (or no award at all). Some of these clients also thought that the decision they received showed a belief that receiving treatment was seen as indicating a condition would improve, or that being in work was taken as evidence a condition was not as severe as it would be had they not been working. This made them feel frustrated and misunderstood.

Some of these clients also attributed their experience not being person-centred to factors that were external to decision-making policy. Some ADP clients felt the ‘points-based system’ did not allow Social Security Scotland to fully understand the impact of their condition. These clients felt the style of the application form was ‘yes/no’ questions without space for elaboration. They felt this was not person-centred as it did not allow them to share the full impact of complex or fluctuating health conditions (e.g. mental health conditions, autoimmune diseases).

“It's just it can't be person-centred if they're using like a one size fits all, a lump tool to make the assessments a point scoring system.” (ADP applicant, unsuccessful)

Other external factors also included clients finding it difficult to get through to Social Security Scotland on the phone and not being able to email them, leading to stress and a feeling that the process was not person-centred. These clients said that these experiences led them to feel that Social Security Scotland did not understand their situation or the impacts of their condition, and that this led to an award they did not feel reflected their situation (or no award at all). As a result of this, they felt as if they were not being heard, trusted or believed.

A common thread throughout sentiments from individuals who disagreed that their experience was person-centred, was that many of them would have liked the opportunity to have some form of dialogue with Social Security Scotland to explain their situation and/or needs.

Most staff observations and interviews reflected that staff adopted a person-centred approach in decision-making. In line with some successful applicants, Case Managers felt they treat each application on its own merits and focus on how the condition affects the client.

“It’s not about the condition or disability [per se], it’s how it impacts on that person.” (Decision Team Manager, PADP)

Practitioners and Decision Support Staff thought the use of decision-making tools such as the collection of supporting information and the use of case discussions supported person-centred decision-making. They felt this was because Case Managers use these to better understand how conditions can affect clients. However, some staff also felt that this could risk resulting in a discussion that focusses on conditions more than impacts on the client as an individual.

Some Case Managers were also observed using previous experiences and understandings of a condition to feed into decision-making. However, this seemed to be mostly to empathise with the severity of a condition. Indeed, some Case Managers were also observed weighing up this information from a case discussion with client information, suggesting a more person-centred approach.

In line with clients’ views on external factors, those staff with experience of decision-making across all types of disability payments felt that the application forms for CDP and PADP allowed for more person-centred decision-making than those for ADP, because the questions were more open. These staff felt that this allowed the client to more fully express the impact of their health condition and provided the Case Manager with a more holistic picture.

Do individuals feel that they are trusted?

81% of Client Satisfaction Survey 2024-25 respondents who applied for ADP or CDP and who had had contact with Social Security Scotland staff agreed or strongly agreed that they felt trusted. Differences across respondent groups were as follows:

• 88% of CDP compared to 81% of ADP respondents agreed or strongly agreed.
• 90% of successful compared to 50% of unsuccessful applicants agreed or strongly agreed.
• 86% of older (65 or over) compared to 75% of younger (16 to 24) respondents agreed or strongly agreed.

In line with the Client Satisfaction Survey 2024-25 findings and the section above, ‘individuals feel that their experience was person-centred’, in focus groups and interviews, successful applicants and review clients who had received either an increase or no change to their award were more likely to say they felt trusted. They felt that the information in the decision letter highlighted that supporting information they had supplied as part of their application was considered and that the decision accurately reflected the impact(s) of their health condition.

“It gives you your dignity and you feel as though you're trusted. You feel as though they're listening to what you're saying. You're not having to, you know, fight for something that you're entitled to anyway.” (CDP scheduled review, increased award)

However, some clients felt that they were not trusted. Reasons provided for this included: receiving no award or an award that they felt did not reflect their circumstances accurately; and being contacted by Social Security Scotland staff for further supporting information when clients felt that they had already provided that specific information. This aligns with the finding that individuals want case managers to fully consider all the information they provide them with.

“I've actually told you all this stuff. I'm not going to make it up.” (ADP applicant, unsuccessful)

Some clients also spoke about the operational side of a trust-based approach. For example, appointees felt that having to verify their identity on each contact with Social Security Scotland was arduous and made it difficult to progress an application, and additionally made them feel as if they were not trusted by Social Security Scotland. Furthermore, some clients felt that the application form made them feel like Social Security Scotland was trying to catch them out, citing that they felt the wording was repetitive. Some clients also spoke about the difficulty of knowing how to answer the questions appropriately in review and application forms, with a couple of clients typifying this experience, mentioning the use of the right “buzzwords”.

“I wouldn't have put half of these things in. But actually the professional, due to their appropriate outcome and buzzwords for want of a better statement, to strengthen the case. Now I do not have the outcome of the case yet but definitely putting in the correct phrases, the correct, dare I say, medical terms or descriptions in some cases or the facilitation that we put in made a huge difference apparently in the submission.” (PADP applicant, awaiting decision)

Staff tended to agree that decision-making is trust-based overall, spontaneously citing using a trust-based approach. However, there were some areas that staff covered that showed the difficulty in balancing a trust-based approach and ensuring that decisions are robust.

Staff mentioned the usefulness of decision-making tools such as supporting information, case discussions, pre-approved online medical guidance such as NHS Inform, and the balance of probabilities in facilitating a trust-based approach. They said these allow for the input of different perspectives, help to mitigate against bias, help Case Managers to expand their knowledge about conditions and their impacts, and, overall, help to achieve a more holistic picture.

However, some Case Managers highlighted the difficulty in using decision-making tools such as NHS Inform and case discussions in cases where there is conflicting information on applications and review forms. Some staff also felt it was harder to apply the balance of probabilities where individuals’ particular situations were not included as examples in the decision-making guidance or where there was limited information available to them. Some of these staff attributed this to the balance of probabilities being open to the interpretation of the individual who is applying it.

“I know some people struggle more with the balance of probabilities aspect of it, whereby we maybe haven't got supporting information or they haven't got the supporting information [that] they feel comfortable with. And that some people have a struggle with making a balance of probability decision.” (CDP, Case Manager)

In addition, one Case Manager felt that there was the potential that decisions could be influenced by bias because most of the staff they worked with come from a similar group, and highlighted the importance of processes that allow staff to mitigate unconscious bias. However, a team leader felt that consistency was improving with additional training.

“From my personal experience in dealing with the organisation, bias is a big problem... like bias and then taking the client’s full circumstances and information provided by their support network, those will be the two where I think the organisation falls short...everyone here comes from a similar group [in terms of background]. You have the odd outlier, that sort of thing, but there's quite a narrow viewpoint of how society functions. My thing was maybe we need to communicate what can impact our colleagues more. Think of it as this whole… how would you treat your neighbour thing runs through so many different veins of life or treat your neighbour how you would want to be treated.” (PADP, Case Manager)

From a benefit-specific perspective, some CDP and PADP Case Managers felt that a wide range of supporting information is used to aid in decision-making for these payments. Some ADP Case Managers also spoke about how they felt it was easier to trust supporting information from professionals over the wider support network because they feel it is more objective.

Do individuals feel that the right decision was made first time?

Official Statistics showed that over the 12-month period between April 2024 and March 2025, a total of 29,530 redeterminations were received for ADP (12% of total reviews and applications conducted within the same time period^[4]), and 3,010 for CDP (7% of total reviews and applications conducted within the same time period^[5]) by Social Security Scotland. For the period between October 2024 and March 2025, a total of 30 redeterminations were received for PADP (1% of total applications received within the same time period^[6]).The proportion of redeterminations allowed (that is, led to a change in outcome) between April 2024 and March 2025^[7] were 50% for ADP, 43% for CDP, and 50% for PADP between October 2024 and March 2025.

Over the 12-month period between April 2024 and March 2025, a total of 6,045 appeals were raised for ADP and 580 for CDP to Social Security Scotland. The average proportion of appeals allowed between April 2024 and March 2025 was 51% for ADP and 55%^[8] for CDP.

59% of Client Satisfaction Survey 2024-25 respondents who applied for ADP or CDP agreed or strongly agreed with the decision they received. Differences across respondent groups were as follows:

• 79% of CDP compared to 57% of ADP respondents agreed or strongly agreed.
• 81% of successful compared to 4% of unsuccessful respondents agreed or strongly agreed.
• 62% of women compared to 56% of men agreed or strongly agreed.

As in the Client Satisfaction Survey 2024-25 data, in focus groups and interviews, those who were successful in obtaining an award or who had received an increase or the same amount from their review, tended to agree that the right decision had been made first time, citing accuracy in the way the decision letters reflected that their situation or condition had been heard and understood.

“I felt like it just sort of justified that I wasn't imagining this behaviour. It wasn't just in my head and it kind of took away like we were saying before the break about that feeling of being gas lit. It took that away and it made me feel justified.” (CDP applicant, successful)

Similarly, for one client, their consultation experience made them feel the right decision was made first time, as they felt the consultation was a dialogue which allowed their situation to be understood.

However, some of these clients did note that they thought that some aspects of their application or review had not been properly considered and were therefore considering requesting a redetermination as they did not feel their award was high enough.

Those who disagreed that the right decision was made first time thought this could be down to Social Security Scotland staff not contacting the most appropriate contacts to receive further supporting information, or not considering the supporting information that they had provided. In line with this, Social Security Scotland ‘s 2024-25 Charter Research showed that several participants who were Partners (people who support clients to use Social Security Scotland’s services or collaborate with Social Security Scotland to inform how the service is delivered - see Methodology) mentioned examples where Social Security Scotland had not fulfilled promises to source supporting information for clients. Other beliefs from interview/focus group data included that Case Managers had not considered how conditions can impact people differently.

Although not directly related to the policy principles, other comments included the feeling from clients that they were not able to communicate their situation properly because the application form was too restrictive, with some ADP clients also feeling the points-based system was inflexible to certain conditions (e.g., autoimmune diseases).

“People with lots of disabilities that really affect their life, that can't be quantified into a score. And I think that's the biggest drawback to it and I spoke to my consultant and she actually gave me a four page letter detailing how this was affecting me and they still, you know, refused.” (ADP applicant, unsuccessful)

Some had also felt unsure about what level and type of detail to include in the form and felt there was insufficient guidance on this. This was further exacerbated by the perceived lack of opportunity to communicate their situation to Social Security Scotland staff directly. This was particularly the case for clients who had had their award reduced at a review and who felt the decision letter made it clear that the Case Manager had misunderstood their situation. Some of these clients felt that there is a need for individuals to have more of an opportunity to explain their situation through communication with Social Security Scotland staff in order to avoid misunderstandings.

Case Managers reported using various sources to help them feel confident that they had made the right decision first time, including information from the client, professionals, and NHS Inform.

Case Managers also reported using internal resources, in some cases, to ensure an accurate decision is made. This included: discussing cases with colleagues to check they are interpreting the guidance correctly; asking their Decision Team Manager to discuss these at daily stand-up meetings; putting guidance queries to Decision Support Staff; or asking for input from Practitioners. These resources were used for both first decisions and reviews.

“Obviously people can put in [a] redetermination if they disagree with the decision that we make. But the decisions that we are making, we’re making based on the information that we have available at that time, and the caring needs that are described.” (Case Manager, CDP)

A few staff members also spoke about the difficulties they face in making sure that the decision is accurate. The section ‘Individuals feel that they are trusted’ highlighted that Case Managers struggled most in areas where there was conflicting or limited information, or where individuals’ particular situations were not included as examples in the decision-making guidance. Decision Support staff also felt that there could be difficulties to decision-making because the information about a client picked up from forms and supporting information, and the way it is understood, can vary a lot from person to person.

“It's so subjective and you will get people that can come to different conclusions and make different decisions, and it won't be incorrect. I think the issue here if you're taking our trust-based approach…is that every decision maker will do different things.... They would all use different tools and…probably it would be inconsistent.” (Decision Support Staff)

When asked about their knowledge and skills in Social Security Scotland’s 2024-25 Charter Research, some staff respondents mentioned specific training needs, including examples that showed the need for further training on the decision-making guidance.

“Due to policy^[9]/guidance changes in the review space it has felt that everything has been turned on its head. It is a side step to the training we had. I have found my confidence in the decisions I make has been eroded. I have asked for retraining but it seems that is not something that is available. Whilst we have excellent staff trying to interpret guidance to train others, it has left us all with second-hand interpretation of the guidance. Training needs to come from learning and development, either in person and/or [online].” (Staff respondent, Charter Research)

Interviewed staff also mentioned other difficulties with regard to decision-making, but these were less commonly spoken about:

• One Case Manager felt that decision-making tools, such as case discussions, are less useful when there is a lack of clarity around the information provided by clients in forms.
• One Case Manager felt that there is operational pressure to get through a certain number of cases a week which can make it difficult for them to use all the decision-making tools available to them.
• One Case Manager felt that there is difficulty in seeking support from Decision Support staff because they approach the decision using guidance without necessarily understanding the specifics of cases.
• One Case Manager felt that support from Decision Support staff was most useful when they interrogated the Case Manager’s thought process, helping the right decision to be made first time.

Do individuals understand their decision and why it was made?

70% of Annual Client Satisfaction Survey 2024-25 respondents who applied for ADP or CDP agreed or strongly agreed that the decision made on their application was explained clearly and 69% agreed or strongly agreed that they understood why it was made. Differences across respondent groups were as follows:

• A higher proportion of CDP respondents (84% and 85% respectively) agreed with these statements, compared to ADP respondents (68% and 67% respectively).
• A higher proportion of successful respondents (88% and 89% respectively) agreed with these statements, compared to unsuccessful respondents (24% and 22% respectively).
• A higher proportion of women (72% and 72% respectively) agreed with these statements, compared to men (67% and 67% respectively).
• 77% of ethnic minority respondents compared to 70% of white respondents agreed or strongly agreed that the decision was explained clearly.

In line with Client Satisfaction Survey 2024-25 findings, in focus groups and interviews, successful applicants or those clients who received an increase or no change in their review award, were more likely to feel that they understood their decision and why it was made.

Generally, clients felt the evidence-based approach to decision-making enabled the process to be non-judgemental and free from bias, as it was based on the information (and supporting information) provided in (or with) the application form or review form. Some commented that the decision letter clearly explained the information that had been considered, because this plainly set out what they had told Social Security Scotland in their application and how that information had been used.

“I've got several pages here of the decision…they've gone back over what I told them and what things I told them that [they] had accepted, how they arrived at their decision. Which was quite interesting to read through – [re]assuring as well, that they have understood and taken notice of what was in the application, and that the detail was all very accurate.” (PADP applicant, successful)

Though not directly related to the policy principles, some (but not all) clients felt that the ADP points-based system was easy to understand. As a result, these clients generally understood why the decision was made. This was also the case for some of those who felt it was the wrong decision and those who disagreed with the outcome; they said that they felt better informed if they were going to reapply.

On the other hand, some clients felt the decision was not well explained in the letter so were not sure how the decision was reached. For example, some recalled the letter saying their child’s needs did not meet the criteria, but not explaining why this was so. Additionally, some ADP applicants felt the wording in the decision letter seemed quite generic, like a ‘standard letter’, and so lacked personalised detail about how the decision was made. Some clients also felt the lack of an explanation of what other information could have been included made the decision letter less useful in informing future applications.

Case Managers reported including a justification in the decision letter for each payment element, even if not awarded or relevant to the client. They believed they referenced where each piece of information came from (e.g. supporting information, a consultation) and any other guidance or structures used (e.g. CDP ‘age and stage’ guidance, the points system for ADP). While having standardised letter templates provides a clear structure, they reported tailoring the wordings within these to the individual client’s situation and language. They also reported collaborative working between Case Managers, with them reviewing each other’s responses to make sure they are clear, short, and succinct.

In line with these findings, overall, 89% of staff respondents to Social Security Scotland’s 2024-25 Charter Research felt confident or very confident to interact effectively with clients who understand information and express themselves in different ways. The 2024-25 Charter Research also showed that some partners said they trusted Social Security Scotland because of their honesty and client-centred ethos. For example, some partner respondents said the information in decision letters had been clear and straightforward with transparent explanations about the decision-making process.

“It seems that Social Security Scotland wants to provide updated information and clear, concise directions. I appreciate that every decision letter includes a full explanation of the decisions made and why; this is helpful for understanding the assessment process, points thresholds, eligibility, etc. and is also helpful as a basis for redeterminations and appeals. I think that Social Security Scotland wants to help people within the parameters of the budget laid out by the Scottish Government (and more indirectly by Westminster).” (Partner respondent, Charter Research)

However, further analysis on the Social Security Scotland Charter 2024-25 research data showed that among those staff who felt less confident, some staff felt that they have difficulty communicating decisions in a transparent and detailed yet inclusive way and difficulty in simplifying wording in decision letters.

“There's not many ways to communicate with clients who express themselves differently. For example, phoning someone hard of hearing or with speech difficulties, I try my best, but often panic and resort to sending letters or requesting information from their GP, which feels discriminatory. […] Also, we've been told to simplify our justifications to make them easier to read, but […] we've not been given any guidance on how to simplify justifications while maintaining their reasoning or transparency.” (Staff respondent, Charter Research)

Furthermore, in interviews, when considering the policy of decision-making being transparent, one Practitioner reported that they felt decision letters can sometimes be a little vague as to why an award has not been given (however this was an outlying view, in terms of the staff perspective).

Do individuals understand why a consultation was needed and do individuals understand the outcome of the consultation?

Client Satisfaction Survey 2024-25 data showed that 5% of respondents who applied for ADP reported that they had had a consultation and 91% of these respondents agreed or strongly agreed that they understood why the consultation was needed.

During interviews and focus groups, it became apparent that some clients were not clear on whether they had had a consultation or not and that some of these clients had mistaken a more informal phone call from Social Security Scotland staff for a consultation. This has previously been found in other research^[10]. However, there were also clients who were more sure and for whom it was clearer from their experience that they had undergone a consultation. Overall, between these two groups, there were differences in experiences of understanding the need for a consultation among clients.

Like survey respondents, the need for a consultation was not questioned among those for whom it was clearer that they had had one, and there was a general consensus among interview and focus group clients that this was not only part of the process, but a positive aspect of it. Indeed, some clients, particularly those with complex or fluctuating conditions, felt consultations were useful in allowing them to ‘have a voice’ and explain how their health conditions impacted their life.

Though no clients for whom it was clearer that they had had a consultation explicitly mentioned the Practitioner’s report that is provided to clients as part of their decision outcome, some clients did talk about how they felt after the consultation which seemed to influence how they felt the consultation went. In line with the findings above, overall, those for whom it was more clear they had gone through a consultation were more likely to feel positive about the outcome of it.

“Medically, she knew what she was speaking about, and mentally, she brought more out of me, she asked me questions and like the other guy said, I felt really good after it…” (ADP consultation, successful)

On the other hand, some clients (for whom it was less clear whether they had had a consultation or an informal call with Social Security Scotland staff) felt that they did not fully understand the purpose of the call in advance, and would have liked more communication in advance to allow them to prepare. This led some clients to believe that Social Security Scotland were trying to ‘catch them out’.

Do individuals feel that their consultation was proportionate, trust-based, and in line with their needs?

Client Satisfaction Survey 2024-25 data showed that 84% of ADP respondents agreed or strongly agreed that the Practitioner understood their disability or health condition(s) and how it affects them.

Amongst clients who had taken part in focus groups and interviews, feedback from those for whom it was more obvious they had had a consultation was generally positive.

Some clients for whom it was more clear they had had a consultation described their experiences in line with a trust-based approach. They described the Practitioner as having been understanding, in line with survey data, as well as caring and taking the time to listen to their situation. These clients said that the consultation felt like a dialogue and, as a result, they felt their situation was fully understood. They were left feeling they had been treated with dignity, fairness, and respect.

“It's a bit daunting just to go on in, not knowing you know...I was meeting the person... but very, very, very quickly... I realised that she was there to do her best to help me.” (ADP consultation, successful)

Some of these clients expressed positively that the consultation was not rushed and felt that they were able to fully explain their situation, indicating that this suited their needs. Some of these clients also felt that consultations were useful in allowing them to ‘have a voice’ and explain how their health conditions impacted their life. This was particularly the case for those with complex or fluctuating conditions,

Some clients who had not had a consultation would have welcomed one or a similar opportunity for dialogue with Social Security Scotland, as an opportunity to explain their needs. These clients had complex or fluctuating conditions and were unsuccessful ADP and CDP applicants. The ADP clients were not aware they could request a consultation (consultations are not used for CDP); and were left feeling that they had not been heard or understood.

Social Security Scotland Charter 2024-25 research showed that around three in ten respondents to the partner survey agreed that client wellbeing had been prioritised during the consultation process for Adult Disability Payment and a similar proportion disagreed. Around two in ten said they neither agreed nor disagreed.

Respondents were also asked to comment on the consultation process. Positive comments described consultations as easy and straightforward. There was praise for Social Security Scotland’s health and social care practitioners who had worked on consultations, with respondents describing them as polite and supportive. Comments said that practitioners had prioritised and focused on client wellbeing as part of consultations.

“Clear that the priority was support, with a clear understanding that the clients required this.” (Partner respondent, Charter Research)

Case Managers and Practitioners felt consultations were used in line with the policy: e.g. that they are used when they are the only way of gathering information that is necessary to make a determination. These staff felt that consultations were rare because of this, and provided examples of this highlighting that consultations have been used for situations in which: Case Managers are experiencing difficulties accessing supporting information; when there is conflicting information on an application or review form; to avoid burden on individuals; or when it could benefit the client (e.g. if the client is potentially underreporting the impacts of their health condition).

Also in line with the policy, these staff felt that consultations were used only to collect the information needed to make a robust determination that could not be gathered by using other decision-making tools, and not to scrutinise information that had already been provided. ADP Case Managers thought that consultations, when used, enable the individual to share how their condition impacts them, thus supporting a person-centred approach. Similarly, staff thought that consultations helped to ensure that decisions were based on the client’s account and not staff’s personal bias or preconceptions. Case Managers and Practitioners also reported that clients can specify preferences for the consultation time and format, ensuring it is suited to their needs.

There was, however, some consensus that there is a need for more consultations and, consequently, more collaborative working between Case Managers and Practitioners. The reasoning for this was that staff feel consultations lead to a quicker and more accurate understanding of clients’ conditions because they are carried out by appropriately trained Practitioners.

Some staff did say that they feel consultations are ‘too formal’ as they are communicated like an official appointment which they anecdotally thought the client may interpret as a ‘test’. There was some desire for less formal communications between Practitioners and clients. Staff also reported that clients had to wait a long time for a consultation which caused stress. The less formal communications option might mitigate this.

A couple of case managers reported cases where they felt they would benefit from a consultation, but Practitioners felt there was enough information provided by the client for a decision and so encouraged the Case Manager to trust the client’s account. On these occasions, case managers reported they would be more confident in their decision if it was informed by a conversation with someone with health or social care training.

“Sometimes [Practitioners] will just say there isn't a need for a consultation. You've got enough information there. It's meant to be trust based. Just make a decision.” (Case Manager, ADP)

Mixed and negative experiences from Social Security Scotland Charter 2024-25 research tended to be about Partners and clients not trusting Practitioners or the consultation process. In one instance, a respondent described their client’s poor experience with a staff member. Another respondent said the client they were supporting was unable to take part in a consultation in their preferred way.

Do individuals feel that their review period is appropriate for them?

Some clients in focus groups and interviews had positive perceptions of review periods - these clients reported understanding why the review period was set and felt it considered their circumstances. They understood there needed to be a review at some point but appreciated the stability of longer review periods, where this was appropriate. Some CDP clients understood that shorter review periods are set because a child’s needs are likely to change in a shorter period.

“He’s four just now and hopefully by the time he's six, you know he will maybe be a bit more independent and need less help with things and so hopefully things will be different for him.” (CDP applicant, successful)

Some clients (particularly ADP clients who had not yet experienced a review), however, were unsure of why their review period was set and felt it was not explained to them. ADP clients reported feeling that review periods sometimes felt too short, if they thought their health condition was not going to change in that time, as they felt it would create a burden of repeating the same information. These clients felt that their review period implied that Social Security Scotland staff had not considered their situation properly. Some ADP clients, most of whom had deteriorating conditions, felt there should be no review periods as they thought that dealing with a health condition is traumatic enough and felt that they needed stability.

Some clients also felt that justifications provided in the decision letter could have been clearer in relation to review periods, as they did not understand why their review period had been decided upon, or felt like assumptions had been made about their health conditions improving.

The staff consensus was that the approach to review periods was well aligned with the policy principles. When deciding on a review period for all payments, staff would consider a variety of factors to make an informed decision based on the individual client’s circumstances. These included the type, severity and stability of health condition; and whether treatments indicated things might improve. They also considered the age of the client to account for transition periods that could affect health conditions, e.g. school transitions (for CDP), or being near end of life (for PADP).

“Why would we review them [PADP applicants on a higher award with a degenerative condition]? It's just putting further stress on them. It's not going to get better.” (PADP, Case Manager)

Some CDP Case Managers felt setting review periods is straightforward because there are key transition points and ‘age and stage’ resources as a guide. This aligns with the evidence from CDP applicants. Staff working on ADP and PADP felt that setting review periods is more challenging for these clients as it depends on how they react to treatments as well as the type of health condition and whether the condition fluctuates. Case Managers and a Decision Team Manager felt that it is easier to award indefinitely to PADP than ADP. This was felt to be because PADP clients were older and more likely to have a health condition that was unlikely to improve. It should also be noted that indefinite awards can only be considered for ADP if the client has been awarded the higher rate for both daily living and mobility. Case Managers were guided on when to award indefinitely, by training and through the input of Practitioners.

Do indefinite awards and person-centred review periods allow for financial planning?

In interviews and focus groups, clients did not speak directly about the nature of their review periods and whether they agreed that this allowed them to plan financially. However, there is evidence about both whether people think review periods are person-centred and whether people feel more in control of their finances and can plan accordingly. This section therefore drew on this evidence to understand if this outcome has been achieved.

As in Section ‘Individuals feel that their review period is appropriate for them’, there was mixed evidence about this, where some clients felt that their situation had been understood and therefore their review period was appropriate. Others felt that their situation had either not been properly understood or considered, or that the decision letter could have been clearer as to the reason for the review period.

“…I don't really understand - I didn't understand, like, I guess you would have to review, so the fact that five years - I don't understand why it's five years. Like, it wasn't really explained, but it's nice to see it there and to know that that's not going to change, but I wasn't quite sure why the five years, like, it wasn't really explained…” (CDP applicant, successful)

As in section: ‘Individuals feel more in control of their finances and can plan accordingly’, some individuals spoke more indirectly about financial planning with regard to their review period. These clients inferred that they had some financial stability until the next review.

“…And it personally gives me more room to breathe, so you know the worry isn't there and planning. Financially, you know, bills and everything else…” (ADP applicant, successful)

Do individuals understand the review process and engage with it and do individuals understand the need for a review or why no review is necessary?

Overall, 83% of Annual Client Panels Survey 2024 respondents who had undergone a scheduled review agreed or strongly agreed that it was clear what the review process involves.

59/72% (case transfer and non case transfer respondents respectively; see Client Panels section in Methodology) of ADP and 71% of CDP survey respondents who had reported a substantial change agreed that the process for telling Social Security Scotland about the change was clear.

Overall, clients in focus groups and interviews who had undergone a review understood from their decision letter that there would be a review and accepted that. Also, in line with survey findings, in focus groups and interviews, those who had undergone a scheduled review were more likely to say that they understand the review process than those who had undergone unscheduled reviews which involve reporting a change to their circumstances.

For scheduled reviews, clients reported that the review process was straightforward and easy and this was particularly noted by those who did not have a change in their circumstances. These clients reported engaging with the process by completing the forms.

“I can say that my experience of it, it was really very uncomplicated and very efficient the way it all happened. I just had an email notification. I think something came through the post as well if I wanted to, you know, review it on paper. I chose to do it online because it was just easy and nothing had changed, so I just opted for there's no changes, my condition is just the same.” (ADP scheduled review, no change in award)

There was more mixed client feedback on the clarity of the review process for those who had undergone an unscheduled review, with more negative feedback coming from those who had also had a decrease in award.

Some unscheduled review clients did feel the review process was clear. They felt that the decision letter or other contact with Social Security Scotland made it clear that they had to report changes of circumstances; and some had done so.

On the other hand, some of these clients whose award had decreased felt the process was unclear, with mention of them not knowing that reporting a change of circumstances would trigger a full review of their payment. Some of these clients demonstrated confusion about what exactly to report with one client highlighting this by saying it was unclear whether to inform Social Security Scotland of what had not changed, as well as what had.

“…in my mind, if I've not told you that something has changed. That means it hasn't changed. So it's the same circumstances. That's not the way they viewed it with this review. Because I hadn't physically mentioned, for example, that I have to put my medication and named pots to know - I take 18 meds a day. I need to separate them all because they're all taken at different times of the day. And because I didn't mention that I was still having to use these pots, they took the points off me and I'm like, how am I supposed to remember absolutely everything that I've told you?” (ADP unscheduled review, decrease in award)

As above, some of these clients reported engaging with the process, for example, by reporting a change in circumstances when their condition worsened. However, a couple of clients reported that as a result of this, their award was reduced and indicated that they regretted engaging in the first place.

“if I'd just ticked the box nothing would have changed, but the fact that I've ticked the box, and then I've went on to explain how my condition has worsened a little bit that's actually - I've shot myself in the foot with that.” (ADP scheduled review, decrease in award)

Some clients also indicated that they did not understand the need for a review for conditions they felt were unchanging (e.g. autism, partial deafness, epilepsy). During the research, these clients focussed on the conditions themselves rather than the corresponding impacts of them to highlight their feelings. This highlights a potential gap in clients’ knowledge of the policy, in that decisions are made on the impacts of the conditions rather than on the conditions themselves.

“…they're like, oh, if your circumstances change, like, in five years, oh, yeah, I'll just get rid of autism. Like, very good. You know?” (ADP, scheduled review, decrease in award)

Do individuals feel that the review was light touch and avoided unnecessary burden?

In decision-making policy, the term light touch is used as shorthand for using relevant information (that is already held by Social Security Scotland) and decision-making tools, where possible, to ensure requests for further information, including supporting information, are necessary and proportionate. By necessary and proportionate, we mean where making a robust determination would not be possible without it.

Annual Client Panels Survey 2024 data revealed that 80% of respondents who had undergone a scheduled review agreed or strongly agreed that it was easy to provide the necessary information during the review process, whilst 12% neither agreed nor disagreed and 8% disagreed or strongly disagreed.

Though questions for unscheduled review^[11] respondents who reported a substantial change of circumstances were not comparatively the same, overall proportions who agreed with positive statements about providing supporting information relevant to the change were lower, with:

• 60/68% of ADP and 67% of CDP survey respondents who agreed that they were only asked for relevant information when telling Social Security Scotland about the change.
• 57/58% of ADP and 67% of CDP survey respondents who agreed that the form for telling Social Security Scotland about the change was easy to complete and submit.
• 51/57% of ADP and 64% of CDP survey respondents who agreed that filling in or providing information about the change did not take too long.

Some interview and focus group clients felt the review process did avoid adding burden or stress to them because they felt that Social Security Scotland were considering information from previous reviews so they did not have to explain everything again.

However, interviews and focus groups also revealed some differences between clients who had scheduled and unscheduled reviews and, again for those who had reported changes in their circumstances. For scheduled reviews, clients are provided with a copy of their most recent determination so that they can make informed decisions when considering if their circumstances have changed. Overall, those who had no changes to their circumstances felt the ’declaration of no change in circumstances’ was well-received, especially if applicants had experienced an arduous first application.

“I think that when they send you the review form, and you can have that option that there's no changes so that you're not having to go through and that - because I was worried, when they actually - before the review, whether it was going to be another whole form, everything else, where I was able to just tick a box and say no changes. I found that helpful.” (ADP, scheduled review, award decreased)

While not strictly part of the decision-making policy being explored in this evaluation, clients who reported a change to their circumstances (both scheduled and unscheduled reviews) were more likely to talk about burden in the sense of perceived long processing times from reporting a change to receiving an outcome.

Further, change of circumstances clients who also did not agree with the review outcome (e.g. across increase, no change, and decrease in review awards) felt that they did not have the opportunity to provide context to the changes in their circumstances. Some of these clients also compared their application and review experiences, saying that they had more direct communication with Social Security Scotland staff with their application, which they preferred. An example that typifies these responses was with one ADP client who felt that they lost their mobility payment because they were exercising more on instruction from their doctor. However, they felt the decision was unfair because their condition still caused them chronic pain.

“And so when you're actually applying it's better to be able to explain that to someone face to face, and now with the modern advances in technology, like, we're all talking on a Zoom meeting, they could have easily [done] that for reviews. You could schedule in a Zoom, a Teams meeting with a one to one over the internet. There's no reason for it not to happen.” (ADP scheduled review, unsuccessful)

Overall, the perception of not being able to provide context left these clients not feeling fully heard or understood. This then led to increased burden on those who challenged the decision.

Staff (Case Managers, Decision Support Staff) tended to agree that, where possible, information from all previous decisions is used to support the review decision, in line with client feedback. Some Case Managers reported collecting further supporting information during reviews only if the client reported a new condition, if the previous information was outdated, or did not reflect the client’s current condition, in line with the policy.

However, Case Managers reported feeling that clients did not always realise that Social Security Scotland use information from previous decisions where still relevant. This meant that they would submit further supporting information which staff felt was arduous and stressful for clients and, in some cases, not needed. In contrast, Case Managers sometimes reported other individuals providing too little information at a review, making it difficult to fully understand their situation.

According to Case Managers and Practitioners, scheduled reviews tended to require more supporting information if the client reports a change relating to a new or worsening condition or if there was limited supporting information from the first decision, as they felt ‘open-ended’ options in the form can lead to clients giving too little information.

Progress towards the anticipated medium-term outcomes

The previous section largely focused on direct impacts on clients of the decision-making process. This section explores medium-term outcomes, which are likely impacted by other factors outside of policy changes. This section aims to provide an insight into how policy changes have contributed to these outcomes, where possible.

Do individuals’ experience is in line with dignity, fairness, and respect?

The Client Satisfaction Survey 2024-25 data showed that 75% of respondents who applied for ADP or CDP agreed that they were treated fairly and respectfully throughout the application process. Differences across respondent groups were as follows:

• 85% of CDP respondents compared to 73% of ADP respondents agreed or strongly agreed.
• 90% of successful compared to 35% of unsuccessful respondents agreed or strongly agreed.
• 79% of older (65 and above) compared to 68% of younger (25 to 34) respondents agreed or strongly agreed.
• 83% of ethnic minority and 75% of white respondents agreed or strongly agreed.
• 72-79% of respondents with all other conditions compared to 65% of respondents with social or behavioural conditions, excluding those with vision (73%) or hearing-related (70%) conditions^[12] agreed or strongly agreed.

Annual Client Panels Survey 2024 data revealed differences in whether respondents felt that they were treated with dignity, fairness, and respect between scheduled and unscheduled review^[13] respondents who had reported a substantial change in circumstances, with scheduled review respondents more likely to agree (81% vs. 58/63%) that Social Security Scotland had treated them with fairness and respect.

In interviews and focus groups there were mixed views on whether individuals felt that their experience was in line with dignity, fairness, and respect. In line with some of the survey findings above, successful applicants or those who had an increase or no change in their review award were more likely (but not always) to say that their experience was in line with dignity, fairness, and respect.

Unprompted, clients raised the concepts of ‘dignity, fairness, and respect’ as aims that Social Security Scotland wanted their clients to experience. Clients viewed this intended outcome positively because they felt this meant the approach avoided ‘trying to trip you up’.

An experience clients said made them feel that they were treated with dignity fairness and respect was the belief that Social Security Scotland staff had taken the time to consider their individual situation when making a decision.

“It makes you feel like they're respecting you, respecting everyone's different; like illnesses, whether you can see it or not see it. Everyone needs to be treated fairly and respectful.” (ADP applicant, successful)

Clients who had had a direct interaction with Social Security Scotland staff mentioned this as their understanding of being treated with dignity, fairness, and respect, citing feeling listened to as well as staff being kind, friendly, and empathetic to their situation.

“I think when you're dealing with organisations like Social Security Scotland and again DWP, there's a tendency for people to speak down to you, very condescending, but I've never had that experience with Social Security Scotland. I felt that they were very respectful when the - anytime I've had to contact them via email, phone, a video link. I do find them very, very respectful.” (ADP scheduled review, award reduced)

However, some clients disagreed that their experience was in line with dignity fairness and respect. These clients felt that their situation or condition had not been understood or that the information they provided Social Security Scotland with had not been properly considered.

“I don't think anybody does that [applies for ADP] lightly because it is such a horrendous process and the people you talk to, I don't think they've got any empathy. I'm being straight with you, they don't come across as being - you know, and it'd be good if you spoke to someone that knew about your condition even or had a slight insight. There doesn't seem to be that there.” (ADP consultation, unsuccessful)

The policy states that Case Managers will gather enough information needed to make a robust decision. Despite this, some clients felt that the indication from decision letters that not all the supporting information contacts that they provided Social Security Scotland with had been contacted made them feel that their situation had not been properly understood and that their experience was therefore not in line with dignity, fairness, and respect.

Like clients, staff spontaneously mentioned dignity, fairness, and respect, as core values that sum up the decision-making approach and Social Security Scotland culture.

“The policy principles create the general scope within which you make the decision. What we do is steeped in the core values of Social Security Scotland, dignity, fairness and respect, and that comes through with every case I handle” (PADP, Case Manager).

Staff mostly spoke about dignity, fairness, and respect in relation to putting clients at the centre of decision-making and approaching decision-making with an open mind.

Do individuals trust in our decision-making?

Before being prompted with any intended outcomes, some clients spoke about feeling validated and reassured when Social Security Scotland had considered their application or review form carefully and gave detailed justifications, contacted their support network, or called them to clarify information.

Some clients elaborated on this by saying they felt that the decision letter explained how the decision was made and made it clear that Social Security Scotland had taken note of, and thought about, what was said in the application and supporting information, both at the initial decision and at review. As a result, they felt heard and believed, and confident Social Security Scotland had understood their situation when making the decision.

“Well, actually both of the letters, the refusal and the acceptance, well, the words clear and concise have been used and I would agree on both counts. The refusal letter I understood why I was being refused and what steps I would have to take if I wanted to proceed and reapply. And again, the acceptance letter was clear and concise everything was easy to understand.” (ADP applicant, successful)

On the other hand, some clients, with successful and unsuccessful outcomes, felt staff had not considered all the supporting information that had been provided or had not contacted all the professionals or support network contacts in their application. They felt that this was the case because some information had not been referenced in their decision letter. This led them to question whether, without having considered all the suggested supporting information, Social Security Scotland could have fully understood their situation. Furthermore, this led them to wonder if other factors, such as biases or preconceptions, had been involved in making the decision.

Do individuals understand that, where entitled, receiving disability benefits is a human right?

Interviews and focus group clients who considered this outcome had mixed feelings about it. Some clients disagreed that, where entitled, receiving disability benefits is a human right. These clients saw the reception of benefits as something that is granted to them. This was the case for both clients who received an award and clients who had received an increase or no change to their award after their review.

“It almost feels like a bonus or something you have to earn. It doesn't feel to me that if you have, you know, if somebody's family has a disability, or you have it that you're entitled to extra. I think it's more like a grace or something… I don't feel like it's a human right that everybody on this planet, you know, if you have a disability that's it, you're going to get extra help. I don't think that's always the case.” (CDP, applicant, successful)

Other clients, though they agreed that the receipt of disability benefits, where entitled, should be a human right, noted that their experience did not align with this. These were clients who were both unsuccessful and who had received a decrease in their award, but also those who had later gone on to be successful in receiving an award after initial unsuccess. Unsuccessful applicants or those who had received a decrease in their award tended to cite Social Security Scotland staff not adequately considering the information they had provided on their form as an experience they felt did not align with the receipt of disability benefits being a human right.

Those who had gone on to be successful mentioned factors external to decision-making policy which they felt did not align with this outcome, such as having a lack of help to complete the application, or seeing the points-based system as unfair.

“…I don't know, it's just wrong. And I just feel that they don't want to give you anything, and they won't give you, and they're not going to help you…” (ADP applicant, successful)

Do individuals understand what is happening and why at each stage of decision-making?

When clients were asked to consider this outcome specifically in focus groups and interviews, clients tended to mention factors that were more related to operational rather than policy aspects of the decision-making process that they felt impacted on their experience of this outcome, such as application progress updates and processing timescales. It is important to note therefore that when considering whether this outcome has been achieved, that external operational factors have arguably more of an impact than policy factors. However, when considering operational factors asked about in the Client Satisfaction Survey 2024-25 data showed that 89% of respondents reported that they did not face barriers in relation to getting the information or updates they needed from Social Security Scotland.

Drawing from clients’ discussions around the outcome: ‘Individuals understand their decision and why it was made’, some evidence can also be applied here for the policy aspects. Clients in interviews and focus groups who were successful in their application or who received an increase or no change in their review award, tended to speak more positively about factors relating to this outcome. Some clients mentioned the decision letter, citing that it clearly explained how the decision was reached. Unsuccessful applicants or those who had received a decrease in their review award tended to feel that it was less clear how the decision was reached in their letter.

Do individuals not feel undue stress or worry?

Client Satisfaction Survey 2024-25 data show that 91% of respondents who applied for ADP or CDP indicated that they could communicate with Social Security Scotland when they wanted to and 88% of respondents indicated that they could communicate with Social Security Scotland how they wanted to.

Similarly to the outcome above: ‘Individuals understand what is happening and why at each stage of decision-making’, though not related to the policy principles, interview and focus group clients mainly spoke about stress or worry with regard to application progress updates. Client Satisfaction Survey 2024-25 data also showed that only 62% of respondents who applied for ADP or CDP agreed or strongly agreed that their application was handled within a reasonable timeframe.

Another way clients spoke about the process reducing stress and worry was with regards to the alleviation of financial pressures. Though not related to the policy, these clients often felt that the outcome of their review or application alleviated financial pressures by providing stability and reducing stress, as they could meet their needs and plan for the future without immediate financial concerns. These findings were from successful applicants or those who had an increase or no change in their review award.

“It does kind of lift some of the stress and worry knowing that you're going to get this money coming in and that's what it's there for - I feel like it's taking a big weight off my shoulders, financially.” (CDP applicant, successful)

Though outwith the scope of decision-making policy, these clients also sometimes spoke about this impact in relation to the form, saying that they felt that it was easy to complete which reportedly mitigated against stress. However, those who were unsuccessful in obtaining an award or who had received a decrease in their review award were more likely to say that the application form was lengthy and not straightforward.

Case managers spoke about how they utilised their role to mitigate against undue stress or worry, where possible. Specifically, they spoke about only phoning clients to ask for further information if they felt they absolutely needed to. They also spoke about using existing information at reviews as much as possible.

“If we have sufficient supporting information and things in place, then there's no need to cause extra stress on that client…There will be scenarios that come up where based on the condition...not much will change. Based on the supporting information we previously had as well and that's still quite up to date, there'll be scenarios where we can make a decision without having to contact the client.” (ADP, Case Manager)

However, Case Managers did say that it is apparent that some clients do not understand what is required of them as they upload too much information. Case managers think that this latter point could potentially cause stress to clients.

Case Managers also reported using phone calls to clients only when needed to collect additional information, to avoid stress and burden on the individual. However, because the questions are more open, CDP and PADP Case Managers reflected that applicants did not always include the right amount of information for them to make an informed decision, which led to ‘call traffic’ to clarify information with applicants.

Do individuals have a positive attitude towards Social Security Scotland and the Scottish social security system?

Client Satisfaction Survey 2024-25 data showed that 67% of respondents who applied for ADP or CDP agreed or strongly agreed that Social Security Scotland is an open and honest organisation. Differences across respondent groups were as follows:

• 80% of CDP compared to 66% of ADP respondents agreed or strongly agreed.
• 83% of successful compared to 28% of unsuccessful respondents agreed or strongly agreed.
• 78% of ethnic minority compared to 67% of white respondents agreed or strongly agreed.

In the qualitative research, those who had direct individual contact with Social Security Scotland staff - whether on the phone or through a consultation - were more likely to have a positive attitude towards the organisation. However, similar to survey data, this also seemed to be tied to outcome, that is, this tended to be the case more if the client was successful or had their review award increase or not change. For example, these clients who also had direct contact with Social Security Scotland staff via phone or consultation were positive about the interactions and described staff as friendly, respectful, and having a ‘human touch’.

“[the previous benefits system] was cutthroat. It was that hard. It was like they were unapproachable, but now it's kind of like they generally actually care, which is good.” (ADP consultation, successful)

On the other hand, clients who were unsuccessful or who had received a reduction in their review award tended to feel more negatively towards Social Security Scotland as they did not feel the correct decision had been made. This was particularly the case where the decision letter did not include reference to some information provided, leading the client to believe it had not been taken into account, or that supporting information was not gathered from all professionals listed in the application.

Do individuals feel more in control of their finances and can plan accordingly?

It should be noted that this outcome was designed to be antecedent to the short-term outcome: ‘Indefinite awards and person-centred review periods allow for financial planning’, e.g. the decision-making aspects underpinning indefinite awards and person-centred review planning lead to individuals feeling more in control of their finances and able to plan accordingly. However, many clients did speak about their direct experience of receiving the payment and how that impacted on this outcome.

Some clients who received an award after applying or who received an increase or no change in their review award often felt that the outcome alleviated financial pressures by providing stability and reducing stress, as they could meet their needs and plan for the future without immediate financial concerns. Some of these clients mentioned review periods specifically, highlighting not having to worry about another review at all (indefinite award clients) or that they understood it and could therefore anticipate their next review.

“I also thought that the two-year review period was fair because part of my condition involved, you know, mental health and I was scheduled to have treatment for post-traumatic stress disorder, so I can imagine they might want to see how that went. So I thought the review period was fair.” (ADP, scheduled review, increase or no change in award)

Clients further highlighted the sense of having more financial control by stating that the payments enabled them to budget for extra support needs, such as activities for children or therapies, and allowed those working to reduce hours when necessary.

Some clients mentioned ways in which the payments helped them have more control over their finances. These payments helped cover essential additional costs like larger bills and transportation to medical appointments. In particular, PADP applicants noted the payment helped to cover heating bills.

“The fact that you can feel a bit more in control of finances, to give you that peace of mind when you've got enough rubbish to deal with at the time. Just a little bit of comfort, a little bit of peace of mind and to know that, yes, I can click the heating on. I don't have to think how am I going to get there or can I get a lift from somebody as you can't afford the taxi.” (PADP applicant, successful)

Even some clients who did not receive successful outcomes appreciated knowing their financial situation, as it allowed them to plan ahead financially.

Clients also mentioned factors external to the policy that impacted on this outcome. Some clients felt that the time taken to receive a decision, especially for ADP applications, hindered their ability to plan ahead, with some saying it impacted their mental health. In addition, confusion arose for some applicants who received payments or changes in payment amounts before receiving official decision letters, causing them concern about potential errors.

Do individuals understand their responsibilities and report any change in circumstances in good time?

For the period between April 2024 and March 2025, Official Statistics show that the total number of reviews that were completed based on people notifying Social Security Scotland of a change in their circumstances was 28,895 for ADP^[14] and 3,135 for CDP^[15].

As reported in section: ‘Individuals understand the review process and engage with it’, some clients felt that the decision letter or other contact with Social Security Scotland made it clear that they had to report changes of circumstances. However, some clients were under the impression that the purpose of reviews was to address any changes of circumstances.

Participants in the research who had experience of this said that they reported a change in their circumstances to Social Security Scotland after something had changed in their condition or situation.

“And then when it came to filling in my, like, updating information, for me again, it was just, I had put in, was waiting on appointments for neurology and things like this, and so it was just updating forms, and so it was just resubmitting saying I've now had the confirmation, this is my diagnosis…” (ADP unscheduled review, increase or no change to award)

However, a smaller number of others did this as a means to change something on their initial application e.g. when they thought they may have underreported something and should be on a higher award, or because of self-made errors in their initial applications.

As in section: ‘Individuals understand the review process and engage with it’, there does seem to be a lack of clarity over what information individuals have to include when reporting a change of circumstances.

Progress towards the anticipated long-term outcomes

This section focuses on wider, societal-level outcomes. As with the medium-term outcomes, these have likely been impacted upon by other factors outside of policy changes and commitments relating to the decision-making policy process.

Do individuals trust in Social Security Scotland?

Client Satisfaction Survey 2024-25 data showed that 69% of respondents who applied for ADP or CDP agreed or strongly agreed that they could trust Social Security Scotland. Differences across respondent groups were as follows:

• 82% of CDP compared to 68% of ADP respondents agreed or strongly agreed.
• 86% of successful compared to 26% of unsuccessful respondents agreed or strongly agreed.
• The 65 or over had the highest agreement, where 73% agreed or strongly agreed, while the 25-34 had the lowest, where 63% agreed or strongly agreed.
• 78% of ethnic minority compared to 69% of white respondents agreed or strongly agreed.
• 59% of respondents with social or behavioural conditions compared to 67%-74% of respondents with other conditions, excluding those with vision (62%) or hearing (61%) related conditions^[16] agreed or strongly agreed.

In interviews and focus groups, successful applicants and those who had received an increase or no change in their review award were more likely (but not exclusively so) to express some trust towards Social Security Scotland, in line with survey data. Some clients linked trust with having communication and direct contact with Social Security Scotland.

Clients also raised similar factors as in section: ‘Individuals trust in our decision-making’, to illustrate their experiences of this outcome. Groups with different outcomes talked about decision letters and the beliefs of whether their condition or situation had been properly understood as well as the implications of whether the supporting information they provided or the contacts they provided had been fully considered.

Do individuals have a positive relationship with Social Security Scotland?

Successful applicants or those who had received an increase or no change in their review award were more positive about their relationship with Social Security Scotland, as they had received the outcome they expected. These clients reported that they felt listened to and valued, citing that Social Security Scotland showed in decision letters that they understood their situation.

“I think because of the way the letter was worded it validated the experience that we live… Which did engender a positive relationship for me because it was like, oh, okay, somebody's taken what I've told them and they've looked at it and gone, your life's actually pretty hard… and you deserve support.” (CDP applicant, successful) 

“You felt you were taken seriously as an individual and your request was actually taken into account, and you were valued.” (ADP consultation, successful)

In line with section: ‘Individuals have a positive attitude towards Social Security Scotland staff and the Scottish social security system’, clients also spoke about their relationship with Social Security Scotland with regard to having direct contact with them. For example, those who had direct contact with Social Security Scotland staff via phone were positive about the interactions and described staff as friendly, respectful, and having a ‘human touch’.

In direct contrast, clients who felt that they had not been given the opportunity to discuss their situation directly with someone at Social Security Scotland negatively impacted client feelings towards the relationship between them and Social Security Scotland.

Some clients also mentioned operational factors such as a lack of updates and difficulty getting through to Social Security Scotland for updates about their application as negatively impacting the relationship between them and Social Security Scotland. Though not directly related to the policy underpinning decision-making, clients felt that updates on application progress could have been improved because they would have liked more transparency in the process to understand decision-making and the outcome.

Do public services treat people with dignity, fairness, and respect?

More data is needed to build up a robust overall picture of whether and how public services treat people with dignity, fairness, and respect.

However, Client Satisfaction Survey 2024-25 data did show that 77% of respondents who applied for ADP and CDP agreed or strongly agreed that they were treated with dignity, 77% agreed or strongly agreed that they were treated with respect, and 71% agreed or strongly agreed that they were treated with fairness.

For interview and focus group clients, positive contact and outcome of award seemed to be the driving factors on whether or not clients agreed that they had been treated with dignity, fairness, and respect. As in Section: ‘Individuals’ experience is in line with dignity, fairness, and respect’, clients who had positive interactions with Social Security Scotland staff were more likely to report being treated with dignity fairness and respect.

Those who did not receive an award or who had had a reduction in their review award and those who had no interactions with staff were more likely (but not always) to disagree that they had been treated with dignity, fairness, and respect by Social Security Scotland, citing lack of opportunity to discuss their situation or condition directly with staff.

Is there reduced stigma regarding disabled people and people with long-term health conditions?

Further research is needed to understand if there is reduced stigma regarding disabled people and people with long-term health conditions. Evidence should be drawn from different sources and societal levels and triangulated to gauge if this impact has been achieved.

Nonetheless, a small number of clients discussed their overall perceptions of this, largely agreeing that this is indeed the case. These participants cited increased visibility of disabled people on the television and better practices in the workplace.

Client Satisfaction Survey data 2024-25 also showed that 85% of respondents who applied for ADP and CDP indicated that they had not felt discriminated against at any point during their experience with Social Security Scotland.

Some interview and focus groups clients also spoke about stigma with regard to their experience with Social Security Scotland specifically. For those who discussed it, there seemed to be a consensus across all outcomes and benefits groups (e.g., including those with successful and unsuccessful application outcomes and increases, no change, and decreases in their review award) that their experience reflected reduced stigma (including internalised stigma) regarding disabled people and people with long-term health conditions.

“[discussing reporting his son’s condition and the internalised stigma he overcame because of his experience] And when I applied for this, you know, CDP, and they were also, like, they did not made me feel anything like, you know, it is a, you know, - what can I say, it is very bad thing or, like, something. They made me feel comfortable, and then I was talking about that, and then I realised that, you know, this is, you know, this - especially in my mind I got free that I am not scared of that thing anymore.” (CDP applicant, successful)

Experiences that were drawn on were from those with rarer or newer conditions such as long-COVID, where people mentioned that being awarded with disability payment was like an acknowledgement that their condition or situation was valid. Other people talked about reduced stigma with regard to how they had been treated, citing empathy, feeling listened to, and feeling that their condition or situation had been understood.

In line with these findings, Social Security Scotland’s 2024-25 Charter Research showed that 92% of staff survey respondents were confident or very confident to deliver a service without discriminating against others in the 2024-25 financial year.

“I believe that all of my colleagues live our values, we treat everyone with dignity, fairness, and respect. I am confident we do deliver a service without discriminating against others.” (Staff respondent, Charter Research)

Do individuals have greater financial security and stability?

Official Statistics show that the total value of payments made for the period between April 2024 and March 2025 was for £2,381,223,400 for ADP, £504,782,620 for CDP, and between October 2024 and March 2025, was £1,765,050 for PADP.

Interview and focus group clients who had received an award after application or who had received an increase or no change in their review award had mixed feelings over whether they felt they had greater financial security and stability. It should be noted however that these mixed views come from the interplay of different factors contributing to this outcome, rather than the decision-making process specifically.

As in the above section: ‘Individuals feel more in control of their finances and can plan accordingly’, some clients spoke directly about this with regard to their review periods, inferring that they do not have to worry about their payment being stopped before the end of their review period.

“… yeah, it was like, to know that at least that's us secure enough to be able to cope with that [until the next review] and have that extra finance in is a massive help to us, so I did like that…” (CDP applicant, successful)

Some clients discussed this directly in relation to their award payment and felt that they did have more financial security and stability. These clients spoke about this specifically with regard to knowing that the payments are coming in, means to them a reduction in financial worries and stress.

“There's things that we do pay for that it's always been a bit of a worry, but it does kind of lift some of the stress and worry knowing that you're going to get this money coming in and that's what it's there for - I feel like it's taking a big weight off my shoulders financially.” (CDP applicant, successful)

Conversely, some review clients who had received an increase or no change in their review award did not feel a sense of stability from receiving payments, noting that they were not intended as income replacement and could not replace lost income.

“I'm still working, so it is just that, it's that kind of extra to help towards fuel expenses because you use your car a lot more or if you're having to rely on taxis and things because it's a day that you're not able to drive, it does give you that buffer, but I certainly wouldn't say it gives you security.” (ADP unscheduled review, increase or no change in award)

Conclusions and considerations for policy and practice

Summary of findings

The following section summarises findings in three sections: client experience and the alignment with policy principles; specifics of the decision-making process; and impacts of decision-making policy. These findings have been drawn from across the data sources used in this evaluation (see Data Sources section in Methodology), primarily commissioned qualitative research with clients and Social Security Scotland staff. It should be borne in mind that this research aimed to explore the experiences of the clients, formal representatives, and staff who took part in the research. However, the findings are not representative of all clients or staff, and cannot indicate the extent to which these experiences occur in the population.

Client experience

Person-centred

Findings on whether client experiences were aligned with a person-centred approach largely depended on the award made.

Those who were more likely to feel they had experienced a person-centred experience were – across both the Client Satisfaction Survey and interview/focus groups - successful applicants, or those who had an increase or no change in their review award. Some of these clients attributed their experiences to feeling that decision letters accurately reflected the impacts of their condition or situation. Some of these clients felt that having direct contact with Social Security Scotland staff in which they felt listened to and empathised with meant that their experience was person-centred.

Those who were more likely to feel their experience was not person-centred were unsuccessful applicants or clients who had received a decrease in their review award. Some felt decision letters did not reflect accurately or fully capture their situation, which to them indicated that Social Security Scotland staff had not understood their situation or the impacts of it. Some of the clients who felt that their situation or condition had not been properly understood expressed a desire to have discussed or explained their situation directly to Social Security Scotland staff.

Clients who felt their experience was not person-centred often also attributed this to areas outwith decision-making policy, such as application forms and phone waiting times. However, the determining factors were similar to those for areas within decision-making policy, such as feeling they were not able to fully explain their situation on the application form, and Social Security Scotland not understanding their situation or the impacts because they were not able to speak to them directly.

Case Managers and other staff spoke about the importance of understanding the impacts of people’s conditions, and demonstrated how they took this into account in their decision-making. They saw decision-making tools as useful resources to do this, allowing them to obtain a more holistic picture of the client’s situation or condition and mitigate against bias, and therefore make the right decision first time.

Staff with experience of decision-making across all types of disability payments felt that the application forms for CDP and PADP allowed for more person-centred decision-making than those for ADP, because the questions were more open.

Trust-based

Findings on whether client experiences were aligned with a trust-based approach largely depended on the award made. Successful applicants or those who had an increase or no change in their review award were likely to feel they had experienced a trust-based experience – this was across both the Client Satisfaction Survey and interview/focus groups. Some of these clients attributed their experiences to feeling that the supporting information they had supplied was considered. Clients also referenced detailed and considered decision letters and efforts from staff to contact their support network or themselves as factors that contributed to this outcome.

Those who were more likely to feel their experience was not trust-based were unsuccessful applicants or clients who had received a decrease in their review award. Some felt the supporting information they provided was not being taken into account, or that it was not gathered from all professionals listed in the application. Clients who felt their experience was not trust-based also attributed this to factors outwith decision-making policy, such as knowing how to answer the questions appropriately in review and application forms, and the repetition of wording on the application form making some feel like Social Security Scotland was trying to ‘catch them out’.

Some Case Managers demonstrated using their prior knowledge about conditions to help them make decisions. Some also highlighted the difficulty in using decision-making tools to fully focus on the impacts in cases where there is conflicting information on applications, review forms, or supporting information. Similarly, some expressed difficulty navigating the balance of probabilities, especially where individuals’ particular situations were not included as examples in the decision-making guidance or where there was limited information available to them.

Some ADP Case Managers also spoke about trusting supporting information from professionals more than from an applicant’s wider support network as they felt it was more objective.

Dignity, fairness, and respect

Individuals’ experiences being in line with dignity, fairness, and respect varied depending on client grouping. Annual Client Panels Survey 2024 data revealed differences across review groups, with unscheduled review clients less likely to agree that their experience aligned with dignity, fairness, and respect than scheduled review clients - though it should be noted that questions varied across these groups. Qualitative data found some differences in experience across outcome groups, with successful applicants or those who received an increase or no change in their review award, likely to feel they had been treated with dignity, fairness and respect.

Decision-making process

Right decision made first time and understanding the decision

Findings on clients’ experiences of the right decision being made first time and their understanding of the decision largely depended on the award made. Perhaps unsurprisingly, successful applicants and those who received an increase or no change in their award at review, were more likely to feel that the right decision had been made first time and that they understood the decision and why it was made. Those who were unsuccessful or received a decrease in their award at review were less likely to feel the right decision was made first time or that they understood the decision.

Decision letters were often referred to as the mechanism for client’s understanding of the decision, with those who agreed with and understood the decision saying that letters accurately captured their situations and clearly justified the decision. Conversely, those who did not agree that they understood the decision and why it was made, felt that the decision letters were unclear and impersonal. Overall, clients were more likely to discuss operational aspects of the decision-making process when considering their understanding of the process, citing updates and processing times as key factors.

Case Managers also spoke about the important role decision letters play in communicating to clients how the decision was made. These staff explained how they justified decisions by clarifying what information they had used, and how they tailored letters to individual situations.

Consultations

For Adult Disability Payment, a consultation can be carried out where a decision cannot be made based on the application and available information. Consultations are a discussion between the client and a health and social care Practitioner employed by Social Security Scotland. They replace routine private sector assessments which the Scottish Government removed when Adult Disability Payment was introduced.

Clients were generally uncertain on whether they had had a consultation, with evidence that clients had mistaken more informal phone calls from Social Security Scotland staff as consultations. This finding aligns with previous Client Satisfaction Survey data^[17]. Therefore, throughout the research it was not always possible to ascertain whether clients had had a formal consultation. Those who had had a consultation were more likely to accept that a consultation was needed, in line with recent survey data, and more likely to feel positive about the outcome of it. These clients described experiencing a trust-based approach, with Practitioners felt to be understanding, caring, and taking the time to listen to them.

Some applicants who had not had a consultation expressed that they would have welcomed a consultation^[18] or a similar opportunity for a dialogue as an opportunity to explain their needs. This tended to be those who had been unsuccessful and/or who had complex or fluctuating conditions.

Among staff, there was consensus that consultations are used in line with guidance, e.g. where it has not been possible to make a decision using other tools such as supporting information or case discussion. Staff felt that consultations take a person-centred and trust-based approach, and that they are used only to seek further information that is necessary to make a decision rather than to scrutinise existing information. However, there was a desire to involve Practitioners further in decision-making, whether that be through consultations or less formal communications with clients.

Reviews and review periods

Feelings were mixed for individuals on whether review periods were appropriate for them. The main drivers for this were whether individuals felt that they understood the reasoning provided for the review period, and whether individuals felt that the review period reflected their circumstances or needs.

Those who understood the reasoning behind the review period and felt that it reflected their circumstances, generally felt it was appropriate. There was some consensus among clients who had had a review that they were able to plan better financially as they knew when their review would be.

Survey and focus group/interview data showed that the review process was easiest and most straightforward for clients who had undergone a scheduled review and who had not experienced a change in their circumstances. Clients who had an increase or no change in their review award were also more likely to feel that the process was straightforward and easy. These clients, overall, were also more likely to accept the need for a review.

Clients who did not feel they understood why the review period was set, or that it did not reflect their circumstances, did not feel the review period was appropriate. This tended to be ADP clients with deteriorating or fluctuating conditions or ADP clients who had not yet experienced a review.

Furthermore, some clients who had conditions such as autism and epilepsy tended to focus on the permanency of these conditions rather than any potentially changing impacts, and questioned why a review was needed at all^[19].

Case Managers described their approach to reviews in line with the policy in that they only sought supporting information if clients reported a new condition, or when previous information was outdated or did not reflect the client’s current condition. They provided an insight into clients’ misunderstandings at review as well, suggesting that some clients maybe did not know that the policy was to use previous information, and therefore some clients tended to submit more supporting information than was needed. Case Managers, as well as Practitioners, also highlighted that they sometimes needed more supporting information for scheduled reviews where changes of circumstances were reported or if there was limited supporting information from the first decision. They felt that this was because the open-ended options in the form can lead to clients giving too little information. Some ADP and PADP Case Managers felt that setting review periods could be complex because of treatment cycles and fluctuating conditions.

Change of circumstances

Official Statistics, and interview and focus group data show that many clients are aware of their responsibilities and are proactively reporting changes to their circumstances. Some clients mentioned the decision letter as well as other contact with Social Security Scotland as the mechanism for making it clear that they had to report changes of circumstances. However, some clients did not understand this and thought that the scheduled review was the point in which they could tell Social Security Scotland about a change to their circumstances. Clients also felt unclear on what they should report specifically when reporting a change of circumstances.

Those who had reported a change in circumstances were overall less positive than those who had not. They were less likely to feel that the process was clear, and more likely to express the time taken to process the review as a burden. Smaller proportions of surveyed clients also agreed that providing information about the change did not take too long and that they were only asked for relevant information. Some clients who had received a decrease in award indicated more uncertainty on what to report and some of these felt that they would have liked an opportunity to discuss their situation with Social Security Scotland staff.

Impacts

Disability benefits as a human right

There was mixed evidence on whether people felt that disability benefits were a human right and this was experienced across all award groups.

Successful applicants or those who had an increase or no change in their review award were more likely to have mixed understandings and feelings, with some discussion over the complexity of whether a benefit that is granted to a person is the same as receiving it being a human right.

Those who were unsuccessful or who had received a decrease in their review award were more likely to highlight that their experience did not align with this outcome, and potentially a tension with the language of ‘human right’.

Undue stress and worry

Clients were more likely to cite operational factors, rather than specifics resulting from decision-making policy, when discussing their experience in relation to feeling undue stress or worry. However, clients did mention factors such as increased financial stability and reduced financial pressures as a result of decisions. Some successful applicants and those who received an increase or no change in their review award also cited the review form being easy to complete as mitigating against stress.

Case Managers spoke about mitigating undue stress or worry by only phoning clients where they felt they needed to and by using relevant existing information at reviews. CDP and PADP Case Managers also mentioned having to call clients more to clarify information when they did not include the right amount of information for them to make an informed decision.

Planning and controlling finances

Clients reported feeling more in control of their finances and being able to plan accordingly in terms of both decision-making processes, as well as the direct experience of receiving the payment. Overall, clients reflected positively on how the outcome of the decision helped in terms of financial control by alleviating financial pressures, improving stability, and allowing them to budget for extra support needs. Some clients mentioned review periods specifically and how these positively impacted their ability to plan ahead. Factors outwith decision-making policy, such as the time taken to receive a decision and payments or changes to payments, negatively impacted feeling in control or being able to plan.

Conclusions

What is working well?

• Overall, there was both quantitative and qualitative evidence of positive experiences across many of the outcomes, including those for applications, reviews, review periods, and consultations. These were mostly experienced by clients who were successful applicants or who had an increase or no change in their review award.
• Decision letters positively impacted experiences of outcomes for successful applicants and those who received an increase or no change in their review award. These clients felt that the letters accurately reflected the impacts of their condition or situation and that the supporting information they had supplied was considered, citing approaches by Social Security Scotland staff as being person-centred and trust-based and the right decision being made first time.
• Case Managers explained how they justified decisions by clarifying what information they had used, and tailored letters to individual situations.
• Case Managers and other staff spoke about the importance of understanding the impacts of people’s conditions and demonstrated how they took this into account in their decision-making, using the decision-making tools to support them.
• Staff with experience of decision-making across all types of disability payments felt that the application forms for CDP and PADP particularly, allowed for person-centred decision-making because the questions are open.
• A key positive factor for clients was the opportunity to have direct interaction with Social Security Scotland staff during the application or review process where they felt that they were able to explain their condition or situation. Again, this was mainly for successful applicants or those who received an increase or no change in their review award.
• Largely, for those who had had a consultation, it was experienced positively. These clients described experiencing a trust-based approach from understanding and caring Practitioners who listened to them. These clients also accepted the need for a consultation, and felt positive about the outcome of it.
• Among staff, there was consensus that consultations are used in line with guidance, e.g. where it has not been possible to make a decision using other tools. Staff felt that consultations take a person-centred and trust-based approach, that they are used only to seek further information that is necessary to make a decision rather than to scrutinise existing information.
• Clients who had no changes to their circumstances and especially, those who had an increase or no change to their review award, reported positive experiences of the review outcomes as well as feeling that their experiences were in line with dignity, fairness, and respect. These clients tended to describe the review process as easy and straightforward, and to accept the need for a review. Some of these clients also cited the review form as being easy to complete and therefore mitigating against stress.
• Clients who reported changes to their circumstances had some positive experiences of the outcomes. Many clients are aware of their responsibilities and are proactively reporting changes to their circumstances. Some clients mentioned the decision letter as well as other contact with Social Security Scotland as the mechanism for making it clear that they had to report changes of circumstances.
• Case Managers described their approach to reviews in line with the policy in that they only sought supporting information if clients reported a new condition, or when previous information was outdated or did not reflect the client’s current condition. They also felt that this would mitigate against undue worry or stress to clients.
• Some clients reported positive experiences of review period outcomes. These clients felt that they understood the reasoning provided for the review period and that the review period reflected their circumstances or needs. These clients also tended to feel that the review period was appropriate for them. Some of these clients also felt that review periods positively impacted their ability to plan ahead.

What are the challenges?

• Negative experiences tended to be indicated or raised by both survey and focus group/interview clients who were unsuccessful applicants or who had received a decrease in their review award. This was consistent across the vast majority of outcomes.
• Many of these clients felt that decision letters were a key factor as to why their experience was not in line with several of the outcomes, including, person-centred, trust-based or that the right decision had been made first time. Several of these clients felt that the decision letter did not reflect their situation accurately or fully capture their situation, which to them indicated that Social Security Scotland staff had not understood their situation or the impacts of it. Some of these clients also felt the supporting information they provided was not being taken into account, or that it was not gathered from all professionals listed in the application.
• Some of these clients felt they were not able to fully explain their situation or condition at application or review. This was particularly the case for unsuccessful applicants or those who had received a reduction in their review award, and those with complex or fluctuating conditions. Survey data indicates that this is especially the case for those with social and behavioural conditions. For ADP specifically, this evidence also indicates that some clients feel the current system did not allow them to fully explain the impact of their conditions.
• Relatedly, another key factor for many of these clients in not feeling that their experience aligned with the outcomes, was not having the opportunity to directly explain their condition or situation and its impacts to Social Security Scotland staff. This was mainly the case for unsuccessful applicants or those who had received a decrease in their review award, and was exacerbated by certain situations, for example, for those who reported a change to their circumstances.
• Clients who felt their experience was not trust-based also discussed factors outwith decision-making policy, highlighting a lack of knowledge of how to answer the questions appropriately in review and application forms. Some of these clients also felt that the application forms had repetitive wording.
• Staff with experience of decision-making across all types of disability payments felt that decision-making was more person-centred for CDP and PADP than for ADP. This was attributed to the openness of questions on application forms for CDP and PADP.
• However, CDP and PADP Case Managers also mentioned having to call clients more to clarify information when they did not include the right amount of information for them to make an informed decision, attributing this to the openness of the forms.
• Some Case Managers highlighted the difficulty in using decision-making tools to focus on impacts in cases where there is conflicting information. Some expressed difficulty navigating the balance of probabilities, where individuals’ particular situations were lacking precedence in the decision-making guidance or where there was limited information available to them. Some also demonstrated the difficulty in not using their prior knowledge about conditions to help them make decisions.
• Outwith decision-making policy, many clients mentioned lack of application progress updates and processing timescales as factors that negatively impacted them understanding what is happening and why at each stage of the process.
• Clients were generally uncertain on whether they had had a consultation. There was evidence that clients had mistaken more informal phone calls from Social Security Scotland staff as consultations.
• Some clients were unsure of why their review period had been set and some felt that the reasoning given in decision letters on review periods could be clearer.
• Clients who did not feel that they understood the reasoning provided in the decision letter for the review period or that the review period reflected their circumstances or needs, were less likely to agree that the review period was appropriate for them.
• Some ADP and PADP Case Managers felt that setting review periods could be complex because of treatment cycles and fluctuating conditions.
• Unscheduled review clients who reported changes to their circumstances were more likely to report negative experiences of the outcomes. Many of these seemed to stem from lack of understanding. These clients were less likely to think the process was clear, some did not understand their responsibility to report a change of circumstances, and some felt unclear on what they should report specifically when reporting a change of circumstances. On the latter point, the same was true for some scheduled review clients who did not have a change of circumstances, where they expressed a lack of clarity on what to report.
• Outwith the policy impact, change of circumstances clients were more likely to express the time taken to process the review as a burden.
• There was some evidence across the data of a wider misunderstanding of whether decisions are focussed on conditions or the impacts of that condition, where some ADP clients felt that the points-based system is condition focussed. This also contributed to clients not knowing what to report on for changes to their circumstances (as above) and to clients misunderstanding the focus on impacts and interpreting the permanency of some conditions (e.g., autism) as if there should be no review.
• Case Managers highlighted that some clients maybe lacked understanding of the policy that previous information will be used to make a decision, emphasising that some clients tended to submit more supporting information at review than was needed for a decision.
• Case Managers and Practitioners felt that the open-ended options on the review forms where changes of circumstances have been reported, as well as limited supporting information from the first decision, could lead to clients giving too little information, increasing the need for them to seek further supporting information.
• The outcome of individuals understanding that disability benefits, where entitled, is a human right was largely not achieved, with clients across all the outcome groups showing either mixed understandings or beliefs (successful applicants/ increase or no change in review award clients) or feelings that their experience did not align with this (unsuccessful applicants/ decrease in review award clients).

Considerations for policy and practice

The considerations discussed in this section have been identified from looking across the challenges described in the progress towards the short-, medium- and long-term outcomes. They also align with those identified in the commissioned qualitative research, building on these with evidence from other sources.

1. It is clear from the findings that decision letters are important to clients’ experiences. In order to maximise the likelihood that the policy outcomes are met, all decision letters regardless of the decision should therefore consistently:

• show clients that, regardless of the decision, they are believed and that the impacts of their condition have been heard and recognised,
• balance the above with a detailed justification of why and how the impacts of their condition do or do not meet the criteria,
• demonstrate to clients that their situation or condition and its relevant impacts have been fully considered, drawing on the application form and explaining how and why different supporting information was gathered and used to inform the decision, and
• justify review periods in relation to the client’s condition or situation and its impacts as well as in relation to when these are likely to change. This will allow clients to feel that they can plan financially and mitigate against financial-related stress.

2. There is a strong desire among clients to have direct communication with Social Security Scotland in order to explain their situation or condition and the impacts more fully, at application, review, and for changes of circumstances.

3. The consultation process should be clearer to clients. There is a lack of awareness for individuals as to whether they have had one, and a perceived lack of clarity around the circumstances in which clients can request and have one.

4. There should be some consideration to the differences between the application and review processes across the disability benefits with regard to how each allows clients to fully express their situation or condition and its impacts.

5. There is a need for further clarity to clients regarding how decisions are made in relation to conditions vs. the related needs. For example: more information upfront about how decisions are made against the eligibility criteria; and more guidance on what to report for a change of circumstances, specifically with reference to conditions and impacts.

6. Case Managers desire more guidance and support to aid in their decision-making. This could take the form of more collaborative working with Practitioners, alongside improvements to the decision-making guidance to include more examples of scenarios.

7. External factors such as application updates, processing timescales, and the points-based system have a significant impact on clients’ experiences of these outcomes and therefore should be considered in tandem to any policy-related improvements.