Decision Making Accuracy
Dear Department for Work and Pensions,
The main principle of a WCA is that it concentrates on a claimant’s ability to work. It regards clinical condition/history as largely irrelevant and the WCA handbook instructs Atos HCPs to use drop-down menus and simplify condition/diagnosis wherever possible for the benefit of DWP Decision Makers (DMs) who are not medically trained. As part of the final assessment process, DMs consider a range of available information including information they might have researched on the internet.
1. How can a DM make an informed, accurate and robust decision if the condition they are researching has not been precisely recorded? For example, a brain tumour may be recorded as "occasional headaches" and a serious spinal injury might be recorded as simply "back pain".
2. Given they are not medically trained, how can DMs interpret and understand information with which they are presented if it uses highly technical medical terminology?
3. Would they be expected to interpret the following, which relates to a very well known condition:
“The estimated rates of this complication are 0.3-4% after total knee arthroplasty and 3-13% after proximal tibial osteotomy. Ischemia, mechanical irritation, traction, crush injury, and laceration can cause intraoperative injury to the peroneal nerve.”
4. Not all information on the internet has been fully authenticated and therefore cannot be regarded as reliable. To which websites are DMs therefore restricted and where is this "safe" list documented?
5. In many cases medical opinion on a particular condition and its short/long term effects can be divided and revolve around some very complicated features of the complaint. How does a DM resolve such dilemmas?
Yours faithfully,
J Newman
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...
References
Visible links
1. http://www.dwp.gov.uk/freedom-of-informa...
Dear J Newman
Please see attached response to your FoI request 3166
Kind regards
DWP Central FoI Team
Dear DWP Adelphi Freedom-of-Information-Request,
Your reply raises a number of worrying issues:
Q1: I am afraid you are very wrong. The WCA manual produced for Atos HCPs instructs them to simplify conditions for (non-medically trained) DMs. My own WCA recorded a condition that required extensive surgery as “back pain” 3 times over. Also the same manual positively discourages HCPs from using free form text in favour of the drop-down menus due to the diagnostic algorithm within Lima.
As quite clearly you laid down procedures are not being followed, what action will you be taking?
Q2: There is a contradiction here – providing information in a “non-technical “manner may well introduce inaccuracy. See comments above, particularly regarding my own WCAs.
What is clear is that compliance is poor.
Q3: Who & where are these HCP’s that DM use? When a DM consults a HCP, where is the record of the conversation kept? What records do you keep of this referral frequency?
Q4: I have in writing that DMs use websites on the internet liberally without any controls other than there supposed experience. The risks are obvious. What corrective action will you be taking?
Q5: Atos HCPs vary widely in relation to medical experience. How can a DM be sure the advice they receive is correct, particularly if medical opinion is divided? Why in this area would a DM not use expertise within the NHS?
Yours sincerely,
J Newman
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...
References
Visible links
1. http://www.dwp.gov.uk/freedom-of-informa...
J Newman left an annotation ()
DWP appears to have no idea of the immensity of the task it is attempting to highjack from the NHS and clearly does not understand that with authority comes accountability. Before long, I can quite see a Decision Maker prosecuted for negligence and that certainly will set the proverbial cat amongst the pigeons.
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 'Decision Making Accuracy'.
I have received a long overdue reminder despite not having received a response to my questions of 30/11. Over to you.
A full history of my FOI request and all correspondence is available on the Internet at this address:
http://www.whatdotheyknow.com/request/de...
Yours faithfully,
J Newman
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...
References
Visible links
1. http://www.dwp.gov.uk/freedom-of-informa...
Dear J Newman
Please see attached response to your FoI request 3660
Kind regards
DWP Central FoI Team
Dear DWP Adelphi Freedom-of-Information-Request,
I am not sure if your latest message constitutes an IR - if not, I am requesting one now on the basis that:
Q1/2: Firstly I would just point out that you have successfully contradicted yourselves: on the one hand you are saying HCPs must record conditions accurately, on the other that they must record in a non-technical manner. There are many conditions where this is simply impossible.
I have presented you with irrefutable evidence that an HCP has not followed correct procedures and asked what you intend to do about it. As the Atos “customer” it is your duty to pursue the matter one way or another, but you claim to have answered my question. You have not.
Q3: Where are these HCPs based and are they available as and when a DM needs one? Using the “evidence-based” philosophy, if you cannot prove that referrals are made, you cannot suggest that they are.
Q4:
a) As regards “.....access to evidence-based guidance on a range of disabling conditions”, how can I find out exactly what this comprises?
b) As I have previously stated, I have in writing from DWP the fact that DMs have uncontrolled access to the internet which they use in the course of decision making. You have not confirmed if this is acceptable practice. If it is not, who should be made aware to take remedial action?
Yours sincerely,
J Newman
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...
References
Visible links
1. http://www.dwp.gov.uk/freedom-of-informa...
Dear J Newman
Please see attached response to your FoI request IR 333
Kind regards
DWP Central FoI Team
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 'Decision Making Accuracy'.
You have confused yourselves here by getting things out of sequence.
My note to you dated 21/12 was sent BEFORE ref 3660 arrived, so VTR 333 was unnecessary. Still outstanding are my related questions dated 22/12.
Over to you again.
A full history of my FOI request and all correspondence is available on the Internet at this address:
http://www.whatdotheyknow.com/request/de...
Yours faithfully,
J Newman
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...
References
Visible links
1. http://www.dwp.gov.uk/freedom-of-informa...
Dear J Newman
Please see attached response to your FoI request IR 335
Kind regards
DWP Central FoI Team
Dear J Newman
Please see attached response to your FoI request IR 22
Kind regards
DWP Central FoI Team
Dear DWP Adelphi Freedom-of-Information-Request,
Your inability to address your own contradictions in itelf says a lot about the process you are trying to defend. I am not sure what you think this achieves - certainly not a victory, as the absence of a clear response clearly means there is not one.
Yours sincerely,
J Newman
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...
References
Visible links
1. http://www.dwp.gov.uk/freedom-of-informa...
We work to defend the right to FOI for everyone
Help us protect your right to hold public authorities to account. Donate and support our work.
Donate Now
Nik Morris left an annotation ()
Excellent questions. I applaud the author. Well done.