Atos HCP qualifications - renewal

The request was partially successful.

Dear Department for Work and Pensions,

Atos HCPs are required to have specific medical qualifications to allow them to undertake WCAs.

1) What process does Atos have in place to ensure that these qualifications are renewed where necessary on time, without lapse?

2) Would Atos be aware immediately of a qualification that had expired and would they immediately suspend the HCP, reassigning upcoming WCAs to other HCPs?

3) Can Atos guarantee without fail, that at the time of every WCA, the HCP's qualifications are absolutely up to date in all respects?

4) If a HCP is found to have qualifications that have lapsed, can you confirm that all the WCAs undertaken whilst unqualified can be identified, that they will automatically be rejected as invalid and DWP advised accordingly?

Yours faithfully,

J Newman

DWP Adelphi Freedom-of-Information-Request, Department for Work and Pensions

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Mr Taylor left an annotation ()

Great work J Newman, and admirable stamina please keep it up.

What is needed is a renewal of taking the Hippocratic oath at regular intervals, and perhaps test them on what it actually means.

Also has anybody considered a class action against the DWP and Atos by their many victims, similar to that reported as being taken by the passengers against Costa Cruises for their negligence and the psychological damage caused. It would be very interesting to see the wealth of evidence presented in court.

J Newman left an annotation ()

Please call me John.

As you well know, you often have to make several passes at the same 'issue' to avoid being rebuffed and to get the answer you are looking for.

On the basis that it is only an adverse legal judgement that will prompt the Government to change tack, I believe a couple of legal challenges are being prepared.

You may have seen the report labelled "spartacus", which exposed areas where the evidence/support DWP claims were proved to be non-existent and others have come to light since. It is the removal of these cornerstones that creates the opportunity.

DWP Adelphi Freedom-of-Information-Request, Department for Work and Pensions

1 Attachment

Dear J Newman

Please see attached response to your FoI request 255

Kind regards

DWP Central FoI Team

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Dear Department for Work and Pensions,

Please pass this on to the person who conducts Freedom of Information reviews.

I am writing to request an internal review of Department for Work and Pensions's handling of my FOI request 'Atos HCP qualifications - renewal'.

In a situation like this you make the rules and stick to them. The rules do not allow for any lapses of any duration or any discretion for any individual to waive the rules. It is very black and white.

Your answer to Q4 (no lapses) is at odds with your answer to Q2 & Q3 (there can be lapses) so please

1)Clarify if there can or cannot be lapses.
2)Directly answer Q4: If a lapse is discovered, are all of the WCAs completed during the lapse written off as invalid – yes or no please? Clearly if the HCP is unqualified, they should be discarded.

The rest of this note is for you to pass onto the information and/or process “owner”.

When there is a legitimate debate over whether or not the currently specified qualifications/experience for becoming an HCP are adequate, to admit here that you cannot guarantee compliance is wholly unacceptable.

Q1:
Yes, the HCP has a responsibility to keep their qualifications up to date, but the primary responsibility is on Atos to run a system that ensures there are no lapses. It is an explicit term of the contract without exception and if they fail, they are in breach and DWP should take action accordingly. Note, HCPs employed by Atos do not necessarily work for the NHS. Some are self employed and the validity/currency of their qualifications is the only way of ensuring they have maintained the required standard.

Q2:
There are absolutely no excuses for lapses nor any provision in any contract, so they must be deemed wholly unacceptable. Membership of the Nursing & Midwifery Council is only renewal every 3 years which is an awfully long time to have no record of what a HCP may have been up to. For all you know, they could have been struck of for gross misconduct 2 years and 11 months previously, but are still working for Atos.
A system that can detect lapses “of a few days” reliably, with minor modification is perfectly able to detect them before they arise. If however the system is unreliable, who knows how long it will take to detect lapses?

Q3:
This is a perfectly valid question and your answer is “no”, you cannot guarantee that an Atos HCP is appropriately qualified at the time of undertaking a WCA. It is perfectly possible to do this as follows:
• At the time of initial approval, Atos logs the expiry date on any relevant qualifications.
• At say 3 months prior to expiry, Atos reminds the HCP that unless renewal is confirmed (say) one month ahead of expiry date, HCP will be suspended from the Atos register.
This could not be simpler and easily be fully automated, particularly for a company that is primarily in IT.

Can I remind you that until one asks, one does not know whether information is recorded or not so there is no need for you to sound so indignant if you do not have something I ask for – just say 'sorry we don’t have it'. The ploy of deliberately not recording information so as to avoid disclosure it is well known.

A full history of my FOI request and all correspondence is available on the Internet at this address:

http://www.whatdotheyknow.com/request/at...

Yours faithfully,

J Newman

DWP Adelphi Freedom-of-Information-Request, Department for Work and Pensions

This is an automated confirmation that your request for information has
been received at the DWP Central FoI Team.

We will forward your request to the relevant information owner within the
Department who will respond to you direct. 

Should you also have any further queries in connection with this request
do please contact us.

For further information on the Freedom of Information Act within DWP
please click on the link below.

[1]http://www.dwp.gov.uk/freedom-of-informa...

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DWP Adelphi Freedom-of-Information-Request, Department for Work and Pensions

Our Ref: FOI 2918-IR87

Dear Mr Newman,

Thank you for your Freedom of Information request dated 18 February 2012
that was received by the Department for Work and Pensions (DWP) Adelphi
on the same date and forwarded, on 20 February for response, to the DWP
Commercial Management of Medical Services (CMMS) Internal Reviewing
Officer who is now known as the Medical Services Contract Correspondence
Team Internal Reviewing Officer.

As Reviewing Officer, I have read your email and accepted this as a
request for an Internal Review. I have therefore conducted a full
investigation into FOI 2813-IR255 with the response FOI 2918-IR87

In your email you asked:

Dear Department for Work and Pensions,

Please pass this on to the person who conducts Freedom of Information
reviews.

I am writing to request an internal review of Department for Work and
Pensions's handling of my FOI request 'Atos HCP qualifications-
renewal'.

In a situation like this you make the rules and stick to them. The rules
do not allow for any lapses of any duration or any discretion for any
individual to waive the rules. It is very black and white.

Your answer to Q4 (no lapses) is at odds with your answer to Q2 & Q3
(there can be lapses) so please

1. Clarify if there can or cannot be lapses.
2. Directly answer Q4: If a lapse is discovered, are all of the
WCAs completed during the lapse written off as invalid - yes or no
please? Clearly if the HCP is unqualified, they should be discarded.

The rest of this note is for you to pass onto the information and/or
process "owner".

When there is a legitimate debate over whether or not the currently
specified
qualifications/experience for becoming an HCP are adequate, to admit
here that you cannot guarantee compliance is wholly unacceptable.

Q1Yes, the HCP has a responsibility to keep their qualifications up
to date, but the primary responsibility is on Atos to run a system that
ensures there are no lapses. It is an explicit term of the contract
without exception and if they fail, they are in breach and DWP should
take action accordingly. Note, HCPs employed by Atos do not necessarily
work for the NHS. Some are self employed and the validity/currency of
their qualifications is the only way of ensuring they have maintained
the required standard.
Q2 There are absolutely no excuses for lapses nor any provision in
any contract, so they must be deemed wholly unacceptable. Membership of
the Nursing & Midwifery Council is only renewal every 3 years which is
an awfully long time to have no record of what a HCP may have been up
to. For all you know, they could have been struck of for gross
misconduct 2 years and 11 months previously, but are still working for
Atos.

A system that can detect lapses "of a few days" reliably, with minor
modification is perfectly able to detect them before they arise. If
however the system is unreliable, who knows how long it will take to
detect lapses?

Q3: This is a perfectly valid question and your answer is "no", you
cannot guarantee that an Atos HCP is appropriately qualified at the time
of undertaking a WCA. It is perfectly possible to do this as follows:
* At the time of initial approval, Atos logs the expiry date on any
relevant qualifications.
* At say 3 months prior to expiry, Atos reminds the HCP that unless
renewal is confirmed (say) one month ahead of expiry date, HCP will be
suspended from the Atos register.
This could not be simpler and easily be fully automated,
particularly for a company that is primarily in IT.

Can I remind you that until one asks, one does not know whether
information is recorded or not so there is no need for you to sound so
indignant if you do not have something I ask for - just say 'sorry we
don't have it'. The ploy of deliberately not recording information so as
to avoid disclosure it is well known.
In response to Q1 the original response explained that it is the
responsibility of the individual Healthcare Professional (HCP) to ensure
that they are fully registered. However the response also went on to say
as part of the response to Q2 that the Medical Director is kept fully
informed and that It has been acknowledged that there have been some
'lapses' of a few days in some individuals Nursing and Midwifery
Council's (NMC) registration, which have been caused by logistical
things such as moving house, delay in NMC receiving the forms, a change
of bank details which can cause a delay in payment etc.
If registration lapses while payment/form is awaited then the nurse is
removed from examining/filework until such times as they are back on the
register.
In response to Q3 the previous response states that it is not possible
to "guarantee without fail" that the HCP's registration is up to date.
You state that you agree that our answer is no but believe that the
answer should be yes by putting a number of control systems in place.

It may help if I explain that the number of full time and sessional
doctors that undertake assessments for Atos Healthcare is currently
around 1000 and therefore it will be almost impossible to guarantee that
there would never be a lapse in registration.

In response to Q4 after checking with Health and Wellbeing Directorate I
can confirm that where it is established that a HCP has undertaken an
assessment where their registration has expired then this assessment
will need to be re-examined as the HCP is not employed on behalf of the
Department.

In respect of your request for an Internal Review I partially uphold
your complaint as the answer to Q4 should have clearly stated whether
where assessments were carried out by an unregistered HCP then where
this is established the assessment should be done again.

If you have any queries about this letter please contact me quoting the
reference number above.

Yours sincerely,

DWP Central FoI Team

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Generally the Commissioner cannot make a decision unless you have
exhausted our own complaints procedure. The Information Commissioner can
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Ian Sandeman left an annotation ()

It was reported a while ago that spot checks at some NHS hospitals showed that some NMC registrations were bogus and some were out of date. It may be the case that some nurses working for Atos have either bogus or lapsed registrations. This could be especially true if the checks are not implemented as you suggest.

Dear Department for Work and Pensions,

Please pass this on to the person who conducts Freedom of Information reviews.

I am writing to request an internal review of Department for Work and Pensions's handling of my FOI request 'Atos HCP qualifications - renewal'.

Original Q4: You have still NOT directly answered the question as it is worded. This is very straightforward - if a WCA has been completed by an HCP who is unqualified (albeit temporary) it is automatically invalid by DWP's own rules. Is this the case or not? What do you mean by "re-examined” as this suggests the decision to use the WCA or not is discretionary in total contravention of the rules you yourselves have laid down? In what circumstances could you possibly accept a report from an unqualified person?

For a dedicated, conscientious HCP, there are NO mitigating circumstances for a lapse in registration. If you allowed your car insurance to lapse due to any of the reasons you are saying are acceptable, do you think your insurer would be so generous and understanding in the event of a claim - of course not.

Note that it is perfectly possible to design and implement a foolproof system as I have described. It is used by a professional institution of which I am a member completely effectively and allows them to know instantly when a membership is on the point of lapsing and act accordingly.

A full history of my FOI request and all correspondence is available on the Internet at this address:
http://www.whatdotheyknow.com/request/at...

Yours faithfully,

J Newman

DWP Adelphi Freedom-of-Information-Request, Department for Work and Pensions

This is an automated confirmation that your request for information has
been received at the DWP Central FoI Team.

We will forward your request to the relevant information owner within the
Department who will respond to you direct. 

Should you also have any further queries in connection with this request
do please contact us.

For further information on the Freedom of Information Act within DWP
please click on the link below.

[1]http://www.dwp.gov.uk/freedom-of-informa...

show quoted sections

References

Visible links
1. http://www.dwp.gov.uk/freedom-of-informa...

DWP Adelphi Freedom-of-Information-Request, Department for Work and Pensions

1 Attachment

Dear Mr Newman,

Please see attached response to your Internal Review request.

Kind regards,

DWP Central FoI Team

From: J Newman [mailto:[FOI #101172 email]]
Sent: 28 May 2012 12:33
To: DWP Adelphi Freedom-of-Information-Request
Subject: Internal review of Freedom of Information request - Atos HCP
qualifications - renewal

Dear Department for Work and Pensions,

Please pass this on to the person who conducts Freedom of
Information reviews.

I am writing to request an internal review of Department for Work
and Pensions's handling of my FOI request 'Atos HCP qualifications
- renewal'.

Original Q4: You have still NOT directly answered the question as
it is worded. This is very straightforward - if a WCA has been
completed by an HCP who is unqualified (albeit temporary) it is
automatically invalid by DWP's own rules. Is this the case or not?
What do you mean by "re-examined" as this suggests the decision to
use the WCA or not is discretionary in total contravention of the
rules you yourselves have laid down? In what circumstances could
you possibly accept a report from an unqualified person?

For a dedicated, conscientious HCP, there are NO mitigating
circumstances for a lapse in registration. If you allowed your car
insurance to lapse due to any of the reasons you are saying are
acceptable, do you think your insurer would be so generous and
understanding in the event of a claim - of course not.

Note that it is perfectly possible to design and implement a
foolproof system as I have described. It is used by a professional
institution of which I am a member completely effectively and
allows them to know instantly when a membership is on the point of
lapsing and act accordingly.

A full history of my FOI request and all correspondence is
available on the Internet at this address:

http://www.whatdotheyknow.com/request/at...

Yours faithfully,

J Newman



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J Newman left an annotation ()

Sadly, DWP has no qualms about bringing FoI legislation into disrepute as well as itself.

A very clear-cut question raised on 20/01/2012 was not actually answered until 26/06/2012 (5 months) and it took one response and 2 x IRRs to get there. DWP then has the gall to say that as they regard the information as “additional” they have not infringed FoI legislation and the 20-day rule.

We will see if the ICO agrees.

All this aside, worth noting the main issues here:

1) Neither DWP or Atos have in place the simple processes needed to ensure that practicing HCPs are ALWAYS correctly qualified without exception. They suggest 100% compliance is an impossible target but it is not, nor is it expensive to achieve, particularly in a company with extensive IT capabilities. Sloppy over really quite an imoportant issue.

2) They have finally accepted that they would have to disregard any WCA performed by an unqualified HCP in any circumstances at all. The reality of course is that the public would never know. I have no doubt at all given the general lack of honesty elsewhere in this process that if it did surface that an HCP had allowed their registration to lapse, DWP & Atos between them would hack up an authorisation process that would allow the WCA result to stand. I cannot imagine for one moment that they would contact the claimant, confess to the error, apologise and rearrange. What the eye doesn’t see, the heart doesn’t grieve over.

B. Adams left an annotation ()

Well done John on your perseverance .. You are correct when you say that the primary responsibility is on Atos to run a system that ensures there are no lapses... As you say, this is in the Contract..

1.1.3 The CONTRACTOR shall ensure that it's registered nurses, whether employed or fee paid, are: 1.1.3.1 fully registered, without restrictions or conditions, with the Nursing and Midwifery Council (NMC).

Similarly in 1.1.1 for other HCP's also in 1.6 and 2.6 which states “The CONTRACTOR shall ensure that all of its Health Care Professional providing Services to the AUTHORITY are accredited in accordance with the requirement to retain registration with the relevant licensing organisation.

The DWP are required to monitor these requirements in the Contract and as the HCP's are further approved by the Secretary of State then as such it would be inconceivable that it could be dismissed so easily as the HCP's sole responsibility. Also it would not say much about the standard of approval if such basics are to be ignored.

Similarly, this could bring about other considerations if the HCP is no longer registered.. e.g. Legitimate expectations that the DWP would use registered HCP's or whether informed consent has actually been given with this misleading expectation and the possibility of assault/battery should a physical examination be carried out by an unregistered HCP without true consent.. good luck John

J Newman left an annotation ()

It rather reminds me of the line "Don't worry madam, I'm a doctor . . . . . ".

An inadvertent lapse of 24 hours in itself arguably doesn't matter - but where then do you then draw the line - 2 days? a week? a month? The only way to avoid the dilemma and the risk of inconsistency is to stick rigidly to the simple rule. It is there for a reason and in this case a good one.

John Slater left an annotation ()

Thinking about this I wonder if this is another potential issue for the Fraud Act and Misconduct in Public Office (both criminal offences). If an HCP carries out an assessment and produces a report then I think a good case could be made that fraud has been committed.

The Fraud Act 2006 states:
Fraud by false representation is defined by Section 2 of the Act as a case where a person makes “any representation as to fact or law ... express or implied" which they know to be untrue or misleading.

Fraud by failing to disclose information is defined by Section 3 of the Act as a case where a person fails to disclose any information to a third party when they are under a legal duty to disclose such information.

Fraud by abuse of position is defined by Section 4 of the Act as a case where a person occupies a position where they are expected to safeguard the financial interests of another person, and abuses that position; this includes cases where the abuse consisted of an omission rather than an overt act.

If the DWP do not have sufficient safeguards in place to ensure that ATOS HCP are ‘legal’ (they can’t pass this off via a contract) and act upon a report produced by said HCP then the Decision Makers involved are guilty of Misconduct in Public Office.

J Newman left an annotation ()

It's the finding out that's the problem. a) it's unlikely DWP would notice and b) even if they did, I doubt there would be the inclination to to anything about it. It seems all semblance of right/wrong and any concept of public service has disappeared and I don't know why.

Interesting to see the Nursing & Midwifery council hitting the headlines only today!!! Huge backlogs of unresolved complaints dating back 5 years undoubtedly involving HCPs still working today potentially for Atos as well as in the NHS. If DWP claims it is unaware of this and the risk of 'dodgy' HCPs working for Atos has been ignored, dereliction of duty is the very least of which they are culpable.

It is hard to pinpoint a single area of the public sector that is performing as one would expect at the moment.

Ian Sandeman left an annotation ()

Even if the DWP were found guilty of negligence etc it is very unlikely that anything at all would happen to help the poor victims of Atos.