Work Capability Assessment

Work and Pensions written question – answered on 9th September 2013.

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Photo of Stephen Timms Stephen Timms Shadow Minister (Work and Pensions)

To ask the Secretary of State for Work and Pensions

(1) what his most recent assessment is of the quality of work capability assessments undertaken on behalf of his Department;

(2) how he monitors the quality of the work capability assessments carried out on behalf of his Department; and if he will make a statement;

(3) what performance indicators are included in the contract between his Department and Atos Healthcare for undertaking work capability assessments; and what recent assessment he has made of the performance of Atos under that contract.

Photo of Mark Hoban Mark Hoban The Minister of State, Department for Work and Pensions

The Department looks at a wide range of indicators to assure Atos Healthcare's performance on work capability assessments, including clearance times; the proportion of customers sent home unseen; complaint handling; the percentage of assessments requiring rework before a final decision can be made; and the quality of assessment reports.

Atos Healthcare are contractually responsible for managing, monitoring and reporting on the quality of assessments that they deliver on behalf of the Department. To monitor quality, Atos has an audit programme in place for all health care professionals developed in conjunction with the Department. This consists of a national statistically significant programme of random audit supported by a rolling programme of individual audit and, where appropriate, individual targeted audit. During this audit, assessment reports are considered against quality criteria developed by the Department and cases graded “A”, “B” or “C” with a C-grade report falling below the standards expected by the Department (although this does not necessarily mean that the advice contained within the report is incorrect).

Atos Healthcare's contract with the Department requires them to report monthly on the results of the national sample. The contractual expectations are that, on a rolling three month basis, less than 5% of reports should fail to meet the standards set by the Department. The monthly audit reports provided to the Department by Atos Healthcare routinely showed that they were meeting the contractual target. Over the past 18 months Atos consistently reported meeting this target, with the latest reported results for face-to-face assessments based on the April 2013 audit showing 5.3% C-grades.

The quality of Atos Healthcare's audit activity is reviewed by a joint team consisting of doctors working for the Chief Medical Adviser to the DWP and senior Atos Healthcare staff. This involves randomly sampling and examining a selection of audited cases from each of Atos Healthcare's audit centres on an annual basis.

During this ongoing quality assurance activity, the Department identified problems both in the quality of assessment reports produced by Atos and in their audit processes, which had failed to identify these problems. Looking at a sample of reports produced following a face-to-face assessment from October 2012 to March 2013, the Department identified the percentage of C-grade cases as 41%.

This level of performance is contractually unacceptable and the Department immediately instructed Atos Healthcare to introduce a quality improvement plan. This was set out in the written ministerial statement made by Lord Freud on 22 July 2013, Hansard, House of Lords, column WS151.

We are working closely with Atos as this plan is taken forwards. The majority of Atos's health care professionals have now been through the retraining and revalidation process and have demonstrated they are meeting the required quality standards. All other professionals are having 100% of their assessment reports audited by senior professionals until they have successfully completed this process. Any that do not meet the required standards by the end of September will have their approval to carry out assessments revoked by the Department. We are confident that these steps are ensuring that the quality of reports currently submitted to the Department meets our expectations but will be monitoring this closely over the coming months.

The Department has also engaged PricewaterhouseCoopers to review the quality assurance processes applied by both Atos and the Department and to provide independent advice on how these may be strengthened going forwards. They are due to report to the Department by early October.

As set out in the written ministerial statement, the Department also intends to bring in new providers to support the delivery of the work capability assessment in order to be as responsive to the needs of the claimants as possible. This work is progressing and a notice will be placed in the Official Journal of the European Union shortly.

A full update will be provided to Parliament in the autumn.

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