Scottish Government Position Paper - Disability Assistance: Assessments
This paper is one of a series providing an update on our position on various matters relating to the development of the devolved social security benefits in Scotland.
The purpose of this paper is to set out the Scottish Government's current position and progress in developing a new approach to face to face assessments. Such assessments may be needed to help establish entitlement to Disability Assistance for Working Age People (our replacement benefit for Personal Independence Payment). As is the case currently, face to face assessments will not be used to determine entitlement to Disability Assistance for Children and Young People (our replacement benefit for Child Disability Living Allowance) or Disability Assistance for Older People (our replacement benefit for Attendance Allowance).
In creating a system of social security that meets the needs of the people of Scotland the Scottish Government is committed to ensuring the values of dignity, fairness and respect are embedded throughout the system. In line with these principles the Scottish Government has sought the views of people with lived experience of engaging with the current benefits system. Social Security Experience Panels made up of over 2400 such people from across Scotland were set up for this purpose and have enabled the Scottish Government to reflect the needs of individuals in the design of Scotland’s social security system. In addition the Disability and Carers Benefits Expert Advisory Group (DACBEAG), which is independent of the Scottish Government, was formed to provide recommendations and advice to Scottish Ministers on the development of policy related to Disability and Carers Assistance. DACBEAG is comprised of experts from a range of professional backgrounds including the Convener of the Scottish Social Services Council, Chief Executive Officer of Inclusion Scotland and Associate Director for Scotland of Joseph Rowntree Foundation.
Engagement with the Experience Panels and DACBEAG has been extremely important in shaping the policy and design of Disability Assistance in Scotland. One of the key areas which they have influenced to date is how entitlement to Assistance should be assessed, and the nature of that process. Listening to the views of people with lived experience of engaging with the current benefits system is one way of ensuring the values of dignity, fairness and respect are embedded throughout Scotland’s social security system.
In a statement to the Scottish Parliament in September 2018, the Cabinet Secretary for Social Security and Older People set out the Scottish Government’s approach to assessments that will assist in determining an individual’s entitlement to Disability Assistance. She announced that to give effect to the principle in the Social Security (Scotland) Act 2018 that no one applying for Scottish Disability Assistance should have to be assessed by a private sector provider, all face to face assessments will be delivered by individuals employed by Social Security Scotland.
The statement reiterated another of the Scottish Government’s long standing commitments to significantly reduce the volume of individuals required to attend a face to face assessment to determine their eligibility to Disability Assistance. The 2018 Act therefore states that a face to face assessment should only be required when it is the only practicable way to make a decision about an individual’s entitlement to assistance. This is based on our view that there are currently too many unnecessary assessments and re-assessments carried out by Department for Work and Pensions assessment providers.
We are redesigning the process of applying for Disability Assistance to create a person centred, clear and accessible application which enables individuals to fully communicate how their disability or condition impacts them. We will provide a choice of application channels including online, telephone, paper forms and in-person. Alongside providing transparent guidance explaining how supporting information is used in the decision making process and examples of the types of information which are useful, this is intended to increase the number of applications in relation to which a determination can be made without recourse to an assessment.
Another measure the Scottish Government is introducing to contribute to the reduction of face to face assessments is to take a person centred approach to deciding on the length of award for Disability Assistance. If an individual has a long term condition and the impact it has on their life is unlikely to change over time they will not be unnecessarily invited to an assessment when their award is reviewed. More information about the duration of entitlement can be found here.
The Scottish Government remains clear that choice and control will be built in to Scotland’s social security system and that a holistic, person centred approach to providing Disability Assistance will be used to ensure the needs of individuals are met. The Scottish Government has identified a number of improvements that will ensure that these principles will be put into action.
Before individual is invited to face to face assessment
In order to ensure that the process of applying for Disability Assistance is transparent, we will provide individuals with clear, accessible, and specific guidance about the criteria that will be used to decide on the assistance they are entitled to, and the information they should provide to inform that decision.
Case Managers will begin making a determination from a position of trust, presuming that the individual has provided a truthful account of how their disability or condition impacts them. Case Managers will assume responsibility for gathering information from various sources suggested by the individual - such as family members, nurse specialists, charity support workers - to support the account they have given of their condition. Consideration will be given to the supporting information that is most relevant in individual cases. If a decision about entitlement cannot be made the default action will be to seek further supporting information, including contacting the individual.
Case Managers will also be able to access information and advice provided by Specialist Advisors who have professional experience in the provision of health and social care. In some instances that may involve the Specialist Advisor answering a specific question that the Case Manager has or may require the advisor to provide more comprehensive input, for example, by reviewing the application and supporting information or suggesting what further supporting information should be obtained. Only in circumstances in which there is no other practicable way to make a decision about entitlement to assistance will an individual be required to attend an assessment.
Being invited to face to face assessment
There will be instances in which it is not feasible to make a decision about an individual’s entitlement to Disability Assistance without a face-to-face assessment. We propose that Social Security Scotland can decide that a face-to-face assessment is necessary only in the following circumstances:
- Where there are inconsistencies in the information provided. This could be where the impact an individual has described their condition or disability has on them is not consistent with the diagnosis or condition;
- To fill a significant gap in the individual’s account of their condition and its impact, where this gap cannot be filled by other supporting information;
- Other circumstances where it is identified that a face-to-face assessment is required for the purposes of robust decision making and auditing.
When invited to attend an assessment an appointment will be made for the individual at an assessment location that suits them, taking into account where they live and their access needs. Home visits will also be made available when required. It will be possible for individuals to rearrange the appointment for a date and time that best suits them.
Social Security Scotland will explain why the individual is required to attend a face to face assessment and will set out what consideration has been given to:
- any preference the individual has expressed about where and how assessments are carried out;
- whether the assessment could be carried out in another way; what distance, if any, the individual is expected to travel;
- the extent to which travelling to the assessment may cause the individual distress, or adversely affect their health.
Case Managers and Assessors
One of the cornerstones of ensuring that individuals are treated with fairness, dignity and respect during the application and assessment process is providing Case Managers and assessors with comprehensive training in line with these core values. The Disability and Carers Benefits Expert Advisory Group have provided advice on this and these proposals are aligned with their recommendations.
Case Managers will require the skills necessary to interpret a range of information from numerous sources and to understand specific conditions in order to put together a clear picture of how an individual’s disability is likely to affect them. It is expected that Case Managers will derive these through a combination of previous experience and Social Security Scotland training.
The Scottish Government proposes that assessors must have professional experience in the provision of health and social care - which for example may include experience gained working in the public or third sector - and be able to evidence time working within a relevant role. The training of assessors will include training on the impact of common health conditions, and wherever possible, will be developed in consultation with and delivered by people with lived experience of health conditions and disabilities.
The Social Security (Scotland) Act 2018 provides that Scottish Ministers may make regulations to require assessments for Disability Assistance to be carried out by people who are ‘suitably qualified’ to do so. The requirement was included to ensure that people with mental health and other complex conditions are assessed by people with an appropriate understanding of their condition or disability. We therefore intend to provide a proportion of assessors with additional training in the impact of mental health conditions and learning disabilities, to enable them to carry out face-to-face assessments of people with these conditions.
At the assessment
The Scottish Government understands the importance of individuals feeling as comfortable as possible during their face to face assessment. It is therefore a right provided in the 2018 Act for individuals to be accompanied to an assessment and to have that person participate in the assessment. Social Security Scotland will also ensure access to advocacy support for those with a disability to access the assistance they are entitled to. That could take the form of, for example, helping an individual to complete an application for Disability Assistance or attending an assessment with them. Due to their condition or disability some adults may need additional support from an individual to access Disability Assistance. Social Security Scotland will meet with both the individual and the person elected to be their appointee to ensure the arrangement is suitable. Recognising that many individuals may have an existing appointee when they transfer to Social Security Scotland, it is important that we do not disrupt these arrangements unnecessarily or place an undue administrative burden on carers. We therefore intend to honour existing appointee’s through a simple administrative process, without the need for a further meeting. If an individual’s appointee is, for whatever reason, not present at the face to face assessment it will not go ahead, and an alternative appointment will be arranged so that the individual’s rights are guaranteed.
Assessments will be audio recorded as standard and individuals will routinely be provided with a copy of the report written by the assessor without having to request it. If an individual appeals Social Security Scotland’s decision regarding their entitlement to assistance, the audio recording of any face to face assessment carried out will be provided to the tribunal. The tribunal can then choose whether to review the audio recording in reaching a decision.
Within the current DWP assessment process, during face to face assessments the assessor can make what are referred to as “informal observations” about the individual they are assessing. That means assessors can draw inferences from such observations about the accuracy of what an individual has written in their self-assessment form. We have received a great deal of negative feedback from individuals about the assumptions made by assessors. However, assessors can, and do, also make informal observations which support the description individuals have given of how their condition affects them. Therefore, the Scottish Government propose that there should be transparency at the assessment when an observation is made and that an individual is given the opportunity to respond to this at the time. The Scottish Government is seeking views on whether clear guidance is required to ensure that the kind of informal observations assessors make and the information they derive from them are appropriate.
After the assessment
Having attended a face to face assessment individuals will be provided with a copy of the report which the assessor has prepared. The report will be used by the Disability Case Manager to inform their decision about the individual’s entitlement to Disability Assistance. Unlike in the DWP system, assessment reports will be an additional source of supporting information to be considered alongside all other information available, rather than disproportionate weight being given to the assessor’s opinion.
The Scottish Government will carry out a wide ranging public consultation on all of our proposals relating to Disability Assistance. Once the responses to the consultation have been analysed the Scottish Government will publish a response and begin to refine our proposals to ensure we deliver Disability Assistance that truly works for the people of Scotland.
Social Security Directorate
All enquiries in relation to this paper should be sent to:
2D-South Victoria Quay