Work and Pensions written question – answered at on 15 December 2009.
To ask the Secretary of State for Work and Pensions with reference to the answer of 10 November 2009, Official Report, column 300W, on Jobcentre Plus: training, what qualifications and experience Atos Healthcare professionals are required to have before making medical assessments on individuals' fitness for work.
The approved health care professionals' (HCPs) role is to carry out an assessment of the functional effects of the customer's disabling condition, and to utilise the information gathered to provide the decision maker with an impartial and independent assessment.
Atos doctors must be fully registered with the General Medical Council without current or previous restrictions, conditions or warnings and hold a licence to practice from the date the GMC issues licences. In addition they must have at least three years post full registration (GMC or EEA-European Economic Area equivalent) experience as a minimum. Alternatively for non EU graduates three years post full registration experience in the doctors native country is required. In individual cases, solely at the discretion of the CMA, the requirements that no conditions or warnings be attached to registration and that the doctor must have a minimum of three years post registration experience, may be waived.
Atos nurses must be fully registered (level 1) Registered General Nurses without current or previous restrictions or cautions with the Nursing and Midwifery Council. In addition they must have at least three years post full registration experience. In individual cases, solely at the discretion of the CMA, the requirements that no cautions be attached to registration and that the nurse must have a minimum of three years post registration experience, may be waived.
Atos Healthcare HCPs are specifically trained to provide decision making authorities with independent, accurate and authoritative advice and reports on the effects of disability.
Initial Training-varies in detail according to which benefit is involved. However all such training follows a similar basic pattern, as follows:
Theoretical Training-Theoretical training commences with a trainer-led theory-based course usually delivered to a group of trainees in a classroom setting. Trainees who are new to the work of Atos Healthcare will receive instruction in such areas as disability analysis, customers rights, equal opportunities and professional standards. Detailed technical information relevant to the benefit concerned is provided. All Atos health care trainers have undergone specific training to prepare them for the role, including practical sessions to enhance their understanding of how adults learn.
Practical Training-Practical Training is the work undertaken by the new recruits that is produced in a controlled environment. For examination centre based assessments the trainee is supervised and appraised by an experienced medical adviser as they complete their introductory cases. In the domiciliary visit based benefits the initial cases are monitored immediately on return to allow feedback to be given without delay.
Demonstration of understanding assessed by multiple choice examination-for incapacity benefit, employment and support allowance and disability living allowance the trainee is required to attain a pass mark in a multiple choice questionnaire before they are allowed to proceed to the practical training. The questionnaire includes questions on the whole range of topics covered in the training course.
Demonstration of understanding by audit-In all benefits the initial cases produced by the trainee are target monitored by an experienced medical adviser and the training cannot be considered as complete until the HCP has demonstrated that their work is acceptable. Whenever any problems are identified appropriate feedback is provided. Further cases are monitored until the work is shown to be satisfactory. If the situation is not rectified the HCP may be required to repeat the entire training process. Continued lack of progress will result in the HCP being offered no further training and no further work.
Approval-All HCPs must be approved by the chief medical adviser to the DWP and separate approval is required for each benefit area in which the HCP is involved. Approval is dependent on successful completion of all stages of their training process and ongoing demonstration that the work being carried out meets a satisfactory standard.
Written Guidelines-As part of the trainees training and ongoing support, HCPs are issued with guidelines pertaining to the benefit involved. These guidance notes provide specific technical advice about the benefit concerned, outline best practise and contain general advice about disability analysis and service to the people with disabilities.
The assessment carried out is different to the more usual type of medical examination in which the HCPs aim is to make a diagnosis and decide on appropriate treatment. A GP or specialist is not usually trained in disability assessment medicine and therefore will often not have specific experience in assessing the disabling effects of medical conditions and the way in which a customer's illness or disability affects them in carrying out of a range of everyday work-related activities. As well as this difference in emphasis within the assessment process, the HCP will, when giving an opinion, be aware of the law relating to benefit entitlement. A specialist on the other hand is less likely to be familiar with the law.
In order to provide independent, accurate and authoritative advice and reports it is not necessary for HCPs to hold specialist registration with the General Medical Council. The DWP chief medical adviser approves HCPs to carry out assessments. Approval is dependent on strict recruitment criteria, completion of a course of training in disability assessment medicine approved by the CMA and evidence of satisfactory performance.
Minimum experience criteria for recruitment are laid down both employed and contracted HCPs.
Yes1 person thinks so
No4 people think not
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Annotations
Ian Sandeman
Posted on 16 Dec 2009 10:28 am (Report this annotation)
To date, Atos Origin and their subsidiaries have refused to provide any details whatsoever of the "guidance" offered to their HCP trainees. Would Mr Shaw care to provide copies of the training questionnaires and the internal guidance notes and directives issued by Atos to their trainees? These would seem to be outwith the scope of the Freedom of Information Act which only applies to government departments and not private companies.
Marie Rabbette
Posted on 17 Dec 2009 12:13 am (Report this annotation)
I had the dubious pleasure of being 'assessed' by an ATOS Origin HCP. He failed to record - on any of the 34 pages of the medical document - the name of my diagnosed progressive neurological disease, any symptoms, disabling effects, ignored the fact that I had been assessed and have in-house care seven days a week, am on morphine - which he described as a strong pain killer- recorded as fact that he had examined me on the couch, which is a lie - and I do not use that word lightly, described me as severely disabled on page 6, then concluded on page 32 that I should be able to return to work in 18 months. I thought the word 'progressive' would have given the game away.
Then I found out that it's actually ATOS Origin's LiMA software that does the assessment, not the HCP! There's no room for human, personal interaction here. Unfortunately, it's the genuinely disabled who are on the receiving end of this appalling, demeaning and discriminatory ESA policy.
None of the answers I gave the HCP who assessed me were included in the final document; it was full of inconsistencies and untruths and that document was then used by a decision maker, with no medical training, who had to make a decision on a disease that is not even listed in the DWP Handbook because it is so rare. I have Adhesive Arachnoiditis. The HCP did not know what it was, the Decision Maker did not know what it was, so I sent a massive amount of research on AA to the DWP to help them understand the disease because I had been placed in the Activities group as opposed to the Support group of ESA. I scored 24 points at the medical.
Anything above 15 can be placed in the Support Group, and considering the fact that I have a progressive neurological disease of the nervous system, I had no reason to doubt that I would be placed in the Support Group. But, if the HCP's do not know what they are doing, and the Decision Makers are basing their decisions on flawed medical evidence and questionable medical reports, how on earth can anyone expect the process to work?
I sent my appeal on the 22/10/09 and when I rang on the 8/12/09 to ask why I had not yet had a re-consideration from them and was told that it had been placed in the pile waiting for appeals on the 5/12/09. After eight weeks nothing had changed so I made a formal complaint to the Chief Exec of the DWP.
I had to stop working just last August, having been disabled for the past 30 years, after working as a social worker for the past twenty years. I have become a statistic just as the effects of ESA are beginning to show. I have to say, it does not look good.