Where a client "fails" the WCA - does the DWP tell GPs not to issue a medical certificate?

P. Smith made this Freedom of Information request to Department for Work and Pensions

This request has been closed to new correspondence from the public body. Contact us if you think it ought be re-opened.

Response to this request is long overdue. By law, under all circumstances, Department for Work and Pensions should have responded by now (details). You can complain by requesting an internal review.

Dear Department for Work and Pensions,

I have heard that if a client "fails" the Work Capability Assessment, the DWP discourages the client's GP from issuing a medical certificate, as they have been found "fit for work".

Is this true in any way?

Given that a large proportion of applicants "fail" the WCA, and given the large number of appeals awaited, this is a worrying suggestion.

What communication(s) are there, if any, between the DWP and a client's GP?

Does the DWP have access to a patient's confidential details?

Thank you very much,

Yours faithfully,

[P. Smith]

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

This is an automated confirmation that your request for information has
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DWP Adelphi Freedom-of-Information-Request, Department for Work and Pensions

1 Attachment

Dear [P. Smith]

Please see attached response to your FoI request.

Kind regards

DWP Central FoI Team

show quoted sections

Dear DWP Adelphi Freedom-of-Information-Request,

This is really deeply worrying because if a patient cannot get a medical certificate, benefit stops immediately, so how are claimants supposed to survive till the appeal is heard?

There is a massive backlog of appeals currently, taking months to process, and patients have to survive somehow till then.

It leads to a strained / undermined relationship between GP and patient.

Most people do not want to have to keep going back to their GP for a medical certificate during the months (not their fault it is taking so long) till appeal- it is traumatic to keep asking for a medical certificate.

Letters from GPs and medical professionals are supposed to be acceptable evidence according to the DWP letters received by claimants, but in practise are COMPLETELY IGNORED by DWP office dealing with the claim, and benefit stopped immediately. They only seem to see medical certificates (fit notes) currently. Is this policy?

This combination of effects means pressure on claimant and GP.

Is this fair and ethical?

Yours sincerely,

[P. Smith]

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.

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Department who will respond to you direct. 

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do please contact us.

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Dear Department for Work and Pensions,

The other thing is - are GPs themselves fully aware of the current typical negative patient experience of a WCA?

Are GPs aware of the associated statistics (which beg many questions as to the validity, fairness and ethics of the WCA process, and decision-making)?

http://research.dwp.gov.uk/asd/workingag...

As well as writing a letter to GPs informing them that a patient has been found fit for work by a WCA conducted by ATOS, does the DWP keep GPs objectively informed about the process, decision-making and associated facts and statistics, so that GPs can judge for themselves about the validity of a WCA, of the ethics of the process, and about a patient's ACTUAL fitness for work, in a REAL LIFE workplace?

How long has the DWP had the right to influence a GP about a patient's fitness for work? Is this s recent thing?

Why is the opinion of a registered nurse regarding a patient's condition, during 45 minutes at a WCA, seen as more important and relevant than that of a consultant or specialist?

Why is it more of a priority for the nurse to record subjective observations such as whether a patient is sweating or not, than getting the facts of a patient's condition correct at a WCA?

Many thanks,

Kind regards,

[P. Smith].

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.

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

Our Ref: FoI 2138

Dear Ms Smith,

Thank you for your Freedom of Information request of 23 July 2011.

You requested the following information:

This is really deeply worrying because if a patient cannot get a
medical certificate, benefit stops immediately, so how are
claimants supposed to survive till the appeal is heard?

There is a massive backlog of appeals currently, taking months to
process, and patients have to survive somehow till then.

It leads to a strained / undermined relationship between GP and
patient.

Most people do not want to have to keep going back to their GP for
a medical certificate during the months (not their fault it is
taking so long) till appeal- it is traumatic to keep asking for a
medical certificate.

Letters from GPs and medical professionals are supposed to be
acceptable evidence according to the DWP letters received by
claimants, but in practise are COMPLETELY IGNORED by DWP office
dealing with the claim, and benefit stopped immediately. They only
seem to see medical certificates (fit notes) currently. Is this
policy?

This combination of effects means pressure on claimant and GP.

Is this fair and ethical?

Where possible Jobcentre Plus phones ESA claimants who have been found
well enough to work after a period of limited capability for work. The
call is made to explain why their benefit has been disallowed and the
next steps available to the claimant. Where the claimant wants to
appeal against the decision on limited capability for work, payments of
ESA can continue during the appeal process. Medical evidence is
required from a GP to support continued payment. Where medical
evidence is not available, moving to Income Support or Jobseeker's
Allowance may be an option and the call provides advice about how to
claim these benefits.
DWP Decision Makers have to consider all the available information
before making a decision on benefit entitlement following a Work
Capability Assessment. Evidence provided by a GP or consultant is very
important and fully considered. However, GPs are unlikely to have the
knowledge to provide comprehensive information about the functional
effects of disability in relation to work capability. Nor are GPs, as
advocates of the patient, in a position to provide independent advice on
benefit entitlement. The Work Capability Assessment is carried out by
specifically trained healthcare professionals who provide objective
advice about the claimant's functional capability.

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

Yours sincerely,

DWP Central FoI Team

------------------------------------------------------------------------
------------------------------

Your right to complain under the Freedom of Information Act

If you are not happy with this response you may request an internal
review by e-mailing [DWP request email] or by
writing to DWP, Central FoI Team, 5th Floor The Adelphi, 1-11, John Adam
Street, London WC2N 6HT. Any review request should be submitted within
two months of the date of this letter.

If you are not content with the outcome of the internal review you may
apply directly to the Information Commissioner's Office for a decision.
Generally the Commissioner cannot make a decision unless you have
exhausted our own complaints procedure. The Information Commissioner can
be contacted at: The Information Commissioner's Office, Wycliffe House,
Water Lane, Wilmslow Cheshire SK9 5AF www.ico.gov.uk

show quoted sections

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

Dear Ms Smith

Thank you for your Freedom of Information request of 23 July

You requested the following information:

Dear Department for Work and Pensions,

The other thing is - are GPs themselves fully aware of the current
typical negative patient experience of a WCA?

Are GPs aware of the associated statistics (which beg many
questions as to the validity, fairness and ethics of the WCA
process, and decision-making)?


http://research.dwp.gov.uk/asd/workingag...
_arc

As well as writing a letter to GPs informing them that a patient
has been found fit for work by a WCA conducted by ATOS, does the
DWP keep GPs objectively informed about the process,
decision-making and associated facts and statistics, so that GPs
can judge for themselves about the validity of a WCA, of the ethics
of the process, and about a patient's ACTUAL fitness for work, in a
REAL LIFE workplace?

How long has the DWP had the right to influence a GP about a
patient's fitness for work? Is this s recent thing?

Why is the opinion of a registered nurse regarding a patient's
condition, during 45 minutes at a WCA, seen as more important and
relevant than that of a consultant or specialist?

Why is it more of a priority for the nurse to record subjective
observations such as whether a patient is sweating or not, than
getting the facts of a patient's condition correct at a WCA?




The Department for Work and Pensions (DWP) can not comment on the
awareness individual GP's may or may not have about the Work Capability
Assessment experience and statistics. GPs have, however, been given
guidance on certification and the Work Capability Assessment. The latest
guidance was published on the DWP website in March (link below).

http://www.dwp.gov.uk/healthcare-profess...

The link was also included in a GP bulletin in April on the Department
of Health website. The DWP and previous departments have notified GPs
about the outcome of medical assessments or examinations for over 20
years in relation to Sickness Benefit, Invalidity Benefit, Severe
Disablement Allowance, Incapacity Benefit and Employment and Support
Allowance.

DWP provides general information and statistics about the Work
Capability Assessment on its website and Directgov. This is available to
GPs as it is to members of the public.

The Work Capability Assessment looks at a person's functional
capabilities but does not consider specific types of employment or
workplaces.

DWP Decision Makers have to consider all the available information
before making a decision on benefit entitlement following a Work
Capability Assessment. Evidence provided by a GP or consultant is very
important and fully considered. However, GPs are unlikely to have the
knowledge to provide comprehensive information about the functional
effects of disability in relation to work capability. Nor are GPs, as
advocates of the patient, in a position to provide independent advice on
benefit entitlement. The Work Capability Assessment is carried out by
specifically trained healthcare professionals who provide objective
advice about the claimant's functional capability.
If you have any queries about this letter please contact me.
Yours sincerely,

DWP Central FoI Team

------------------------------------------------------------------------
------------------------------

Your right to complain under the Freedom of Information Act

If you are not happy with this response you may request an internal
review by e-mailing [DWP request email] or by
writing to DWP, Central FoI Team, 5th Floor The Adelphi, 1-11, John Adam
Street, London WC2N 6HT. Any review request should be submitted within
two months of the date of this letter.

If you are not content with the outcome of the internal review you may
apply directly to the Information Commissioner's Office for a decision.
Generally the Commissioner cannot make a decision unless you have
exhausted our own complaints procedure. The Information Commissioner can
be contacted at: The Information Commissioner's Office, Wycliffe House,
Water Lane, Wilmslow Cheshire SK9 5AF www.ico.gov.uk

show quoted sections

Mr Taylor left an annotation ()

In their response the DWP said:
"Where possible Jobcentre Plus phones ESA claimants who have been found
well enough to work after a period of limited capability for work. The
call is made to explain why their benefit has been disallowed and the
next steps available to the claimant. Where the claimant wants to
appeal against the decision on limited capability for work, payments of
ESA can continue during the appeal process. Medical evidence is
required from a GP to support continued payment. Where medical
evidence is not available, moving to Income Support or Jobseeker's
Allowance may be an option and the call provides advice about how to
claim these benefits."
http://www.whatdotheyknow.com/request/wh...

"Where possible Jobcentre Plus phones ESA claimants " So are not all their customers entitled to the same level of service? And why is this advice not given in writing to all their customers rather they a phone call, if they get lucky?

Dear DWP Adelphi Freedom-of-Information-Request,

Re: "However, GPs are unlikely to have the knowledge to provide comprehensive information about the functional effects of disability in relation to work capability."

And ATOS Healthcare staff do not have the MEDICAL background to be able to inform their reports, either. So is it a clear choice between medical knowledge and knowledge of "functional effects"?

Re: "Nor are GPs, as advocates of the patient, in a position to provide independent advice on benefit entitlement."

Is this the official DWP view of GPs - as a patients biased advocate? The DWP would rather trust the (also biased) opinion of an employee of a private money-making company?

Re: "The Work Capability Assessment is carried out by specifically trained healthcare professionals who provide objective advice about the claimant's functional capability."

How can you claim that they provide "objective" advice in the light of so many appeals, so many people experiencing biased / fixed WCAs (read the forums online), and when so many disability charities are questioning this?

Who have MEDICAL training to the extent that a GP does?

Also, the DWP A-Z list of medical conditions and the NHS Choices website list of conditions that ATOS and DWP staff are supposed to refer to, are both patchy and incomplete and exclude several conditions.

Yours sincerely,

[P. Smith]

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

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Dear DWP Adelphi Freedom-of-Information-Request,

Re: "However, GPs are unlikely to have the knowledge to provide comprehensive information about the functional effects of disability in relation to work capability."

And ATOS Healthcare staff do not have the MEDICAL background to be able to inform their reports, either. So is it a clear choice between medical knowledge and knowledge of "functional effects"?

Re: "Nor are GPs, as advocates of the patient, in a position to provide independent advice on benefit entitlement."

Is this the official DWP view of GPs - as a patients biased advocate? The DWP would rather trust the (also biased) opinion of an employee of a private money-making company?

Re: "The Work Capability Assessment is carried out by specifically trained healthcare professionals who provide objective advice about the claimant's functional capability."

Who have MEDICAL training to the extent that a GP does?

Also, the DWP A-Z list of medical conditions and the NHS Choices website list of conditions that ATOS and DWP staff are supposed to refer to are both patchy and exclude several conditions.

Yours sincerely,

[P. Smith]

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.

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Dear Department for Work and Pensions,

I would like to know what (secret?) general instructions as to the interpretation of a patient/ claimant's case / condition are given by Government (or whoever) to DWP and ATOS about how they execute a WCA, write reports, make decisions about and assess a claimant. (They surely contain tight targets and limits, and ways of denying genuine claims, but obviously not in such words, and using clever language.)

I would like to see a copy of the document(s) that for example must surely instruct an ATOS WCA assessor to miss out or misinterpret things that a claimant has said / not put things a claimant has said in the appropriate part of the report where they should be assessed, to write irrelevant and biased observations about a claimant's behaviour, dress etc on the report etc.

The body of evidence (see online forums, disability organisation websites etc.) re: unsuccessful claimants who have genuine conditions, the large number of appeals would statistically indicate institutionalised / inherent bias / inherent POLICY and POLITICS in the process. You don't need to be Sherlock Holmes to deduce this.

What (secret?) government (or whoever) instructions are causing this bias / disability discrimination? Please would you supply a copy.

Disability or ill health can happen to anyone, out of the blue, and age happens to us all. Most people want to work, yet the process of claiming benefits seems to assume all claimants as dishonest etc. These assumptions are surely discriminatory?

Thank you,

Yours faithfully,

[P. Smith]

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.

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Dear Department for Work and Pensions,

I would like to see the instructions, documents (or other communications) that list / outline / detail the routine approaches, attitudes, stratgies, wordings, instruments, indirect devices and any other means by which a claim is to - in effect / amount to - be dismissed, and disability denied.

I would like to see the official rationale / justification for this document / for the approach of disability denial.

I would like to see the associated targets for denial of benefits, that must surely exist?

Does the DWP have a statistic for the number of suicides resulting from the denial of sickness / disability benefits?

Many thanks,

Yours faithfully,

[P. Smith]

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.

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

1 Attachment

Dear [P. Smith]

Please see attached response to your FoI request.

Kind regards

DWP Central FoI Team

show quoted sections

J Newman left an annotation ()

Hi. I have been following a similar track regarding GPs vs HCPs and my last response contains the same paragraphs as your does here. The DWP guys that deal with these requests have talked themselves in a circle that is riddled with contradictions, but as they have no authority, there seems little point in pursuing it here any further - I don't think they realise how bad their answers make DWP look.

A. Cuerden left an annotation ()

The DWP response is a lie: When I underwent an appeal, my GP told me that the DWP had specifically asked them not to issue medical certificates.

J Newman left an annotation ()

Really. I have an outstanding request for copies of all correspondence between DWP & NHS over my WCAs. Interesting to see what they come up with.

There is a form Atos/DWP use to ask GPs for info. Ironically most of the questions are about capability to work - the very thing they keep telling us GPs are not trained to judge!!!

Dear DWP Adelphi Freedom-of-Information-Request,

Based also on the annotation below in quotes that was attached to my freedom of information request, it would appear that this IS going on. ( The DWP telling / pressurising GPs not to issue medical certificates.)

"The DWP response is a lie: When I underwent an appeal, my GP told me that the DWP had specifically asked them not to issue medical certificates."

If this IS going on, who instigated it / approved it?

I would like to see, please ANY related documents, instructions, guidelines etc that would reflect the truth of this / cause this to happen - any directives to DWP from government policy makers / departments - and from ANYBODY else please.

If it does happen - is this lawful? Isn't this a violation of Human Rights?

At the least it is SECRETIVE NEGATIVE INTERFERENCE and MANIPULATION.

Thank you,

Yours sincerely,

[P. Smith]

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

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

1 Attachment

Dear [P. Smith]

Please see attached response to your FoI request.

Kind regards

DWP Central FoI Team

show quoted sections

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

1 Attachment

Dear [P. Smith]

Please see attached response to your FoI request.

Kind regards

DWP Central FoI Team

show quoted sections

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

1 Attachment

Dear [P. Smith]

Please see attached response to your FoI request.

Kind regards

DWP Central FoI Team

show quoted sections

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

1 Attachment

Dear [P. Smith]

Please see attachment to accompany the response to your FoI request 339.

Kind regards

DWP Central FoI Team

show quoted sections

Dear DWP Adelphi Freedom-of-Information-Request,

Regarding:

"Employment and Support Allowance
Our direct dial number is Code Number
Textphone users with speech or hearing difficulties call Code Number
If you get in touch with us, tell us this reference number Date / /
Limited capability for work assessment only

Dear Doctor

Patient's name Address info
Date of birth / /

This patient has been claiming Employment and
and Support Support Allowance.
For Allowance.
We recently assessed their ability to work using the Limited Capability for Work Assessment.
We decided that your patient is capable of work from / / .
This is based on a medical assessment we arranged and your patient attended on / /

medical information you provided
information your patient gave us.

This means you do not have to give your patient any more medical statements for benefit
purposes.
But you may have to give your patient new medical statements if
G they decide to appeal against our decision
G their condition gets significantly worse
G they have a new medical condition.

We have sent your patient a summary of the Limited Capability for Work Assessment.
ESA65B 04/10"

Particularly the middle bit: " medical information you provided ... information your patient gave us. "

Particularly re:

"This is based on a medical assessment we arranged and your patient attended on / / "

We all now know that the WCA undertaken by ATOS is a set-up. (Please see The Spartacus Report below.)

I have heard that in a significant number of cases medical information sent to the DWP by the patient is not used in the assessment / decision-making process. It can be "stored" ("lost"?) instead. I have heard that information sent to the DWP is not shared with ATOS.

How can a GP be sure that if a patient sends in medical information, or their GP send in medical information - it will be actually used?

Does the DWP / ATOS tell GPs how the patient was actually assessed and can a GP trust the DWOP / ATOS with what EXACT information?

Also regarding:
"We have sent your patient a summary of the Limited Capability for Work Assessment. ESA65B 04/10"

Is the GP sent a copy of this summary?

Yours sincerely,

[P. Smith].

The Spartacus Report. http://www.ekklesia.co.uk/files/response...

http://www.dailymail.co.uk/debate/articl...

Even the Daily Mail is disapproving of the government's callous dishonesty.

http://www.ekklesia.co.uk/node/16017
http://www.heraldscotland.com/news/home-...

The full report, 'Responsible Reform' is being made available online at Ekklesia and elsewhere. See: http://www.ekklesia.co.uk/responsibleref...

An easy-read version has been made available by United Response here: http://bit.ly/xy0elw

The Spartacus twibbon: http://twibbon.com/join/spartacusreport

The Guardian article by Sue Marsh, 'Disabled people listened to on welfare plans? It's a government sham' - http://tinyurl.com/7skv7rc

The Broken of Britain: http://thebrokenofbritain.blogspot.com/

Diary of a Benefit Scrounger: http://diaryofabenefitscrounger.blogspot...

Press release here: http://www.ekklesia.co.uk/node/16008

Tweeting with the hashtag #spartacusreport and use that tag to follow what is going on

DLA coverage from Ekklesia: http://www.ekklesia.co.uk/disabilitylivi...

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

1 Attachment

Dear [P. Smith]

Please see attached response to your FoI request.

Kind regards

DWP Central FoI Team

show quoted sections

P. Smith left an annotation ()

DWP Central Freedom of Information Team
Annex A

e-mail: freedom-of-information-re

[email address]

Our Ref: IR 16

16 February 2012
Annex A

Dear Pat Smith

Thank you for your Freedom of Information request received on 12 January 2012 in which you
say:

“I have heard that in a significant number of cases medical information sent to the DWP by the
patient is not used in the assessment / decision-making process. It can be "stored" ("lost"?)
instead. I have heard that information sent to the DWP is not shared with ATOS.

How can a GP be sure that if a patient sends in medical information, or their GP send in medical
information - it will be actually used?

Does the DWP / ATOS tell GPs how the patient was actually assessed and can a GP trust the
DWOP / ATOS with what EXACT information?

Also
regarding:
"We have sent your patient a summary of the Limited Capability for Work Assessment. ESA65B
04/10"

Is the GP sent a copy of this summary?”

HCPs are expected to consider any additional medical evidence presented to them at the
assessment by the claimant. However, benefit entitlement is determined by DWP Decision
Makers (DM), not Atos Healthcare. In order to make a decision on benefit entitlement the DM
considers all the available evidence not just the reports received from Atos Healthcare. Further
evidence may include the claimant’s ‘self assessment’, reports from GPs, hospital doctors and
other clinicians. Atos Healthcare do not inform a GP how a claimant was assessed.

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

DWP Central FoI Team

Dear DWP Adelphi Freedom-of-Information-Request,

Please supply the public, via this website, with a list of and copy of any communications / documents from the DWP to a patient's GP, and from a GP to the DWP, arising from a patient's claim of disability or sickness benefit - at any stage from intiial claim to appeal and afterwards.

Many thanks,

Yours sincerely,

[P. Smith]

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

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been received at the DWP Central FoI Team.

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P. Smith left an annotation ()

From PULSE

Revealed: DWP submission to GMC on urging 'return to work'

By Andrew McNicoll | 13 Oct 2011

Exclusive The Department of Work and Pensions urged the GMC to consider return to work as ‘an important indicator of successful clinical treatment' when reviewing its Good Medical Practice guidance, a document obtained by Pulse reveals.

Related articles
GPs face GMC duty on ‘back to work' drive
Letter: ‘Back to work' is about holistic care

Last week, we revealed a revised draft of Good medical Practice included a new duty for doctors ‘to encourage patients with long-term conditions to stay in, or return to employment'.

The move prompted concerns that the GMC had been ‘pressurised' by the Government to enlist GPs in the coalition's benefit crackdown, with the regulator admitting the DWP had fed into the draft document.

The DWP has now released its response to the GMC's initial consultation on the new Good Medical Practice guidance. It recommends GPs should take account of a patient's ‘work status' when assessing them and that the medical profession's core ethical guidance should better recognise the ‘principal that work is an important determinant of health'.

The DWP submission states: ‘The principle that work can have a significantly positive impact on recovery from physical and psychological illness is missing from the current edition of Good Medical Practice.'

A DWP spokesperson said: ‘We would be keen to see consideration of work-related issues included. But the DWP has at no time suggested this be a duty - this is a matter for the GMC.'

Dr Daryl Mullen, a GP in Wigan, said: ‘If anyone has a duty to get people back to work I'd have thought it would be the government, can we get them struck off if they fail?'

P. Smith left an annotation ()

Also from PULSE

GPs face GMC duty on ‘back to work’ drive

By Andrew McNicoll | 04 Oct 2011

Exclusive GPs are set to be required to encourage patients to go back to work as part of their responsibilities to the GMC, under changes to the regulator's core ethical guidance drafted with input from the Department of Work and Pensions (DWP).

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A draft revised version of Good Medical Practice, presented to GMC Council last week, included a new duty ‘to encourage patients with long-term conditions to stay in, or return to, employment'.

The GMC told Pulse a submission from the DWP had fed into the draft document, amid fears from GPs over ‘pressure from Government' to enlist doctors in the coalition's benefit crackdown.

The controversial requirement comes as part of a raft of proposed changes in the first major review of Good Medical Practice for five years. But it has prompted outrage among GPs and debate among GMC Council members, who have demanded clarification on the change.

GMC officials said the proposal will be reworded ahead of a public consultation later this month, with the redraft likely to substitute ‘employment' for ‘meaningful activity'.

Niall Dickson, GMC chief executive, said the draft was based on ‘a lot of evidence that people having productive activity can be life-enhancing'.

He said: ‘We don't want to suggest doctors become policemen of the state. It has to be where it is in the patient's best interest that encouragement and support is given.'

But many GPs responded angrily to the proposal, claiming it ignored the complexities of getting patients into work and pressured doctors into putting the needs of the Government ahead of patients. Click here to join the debate in the Pulse forum.

Dr Rob Barnett, secretary of Liverpool LMC, said: ‘I'm a GP, not an employment adviser.'

'GPs have a responsibility to get patients as fit as possible and if that helps get them into work then that's great. However, I'm working in an area of high unemployment. It may be OK for the GMC in London to propose things like this but the reality here is that there are very few jobs around.'

Dr Margaret McCartney, a GP in Glasgow, said: ‘Work in general is good for people, but it is not right for everyone all the time. Doctors need to be quite clear on where our responsibilities are – it is patients first.'

'The reality for people who have complex and multiple chronic illnesses is not well represented in the literature to date. The evidence base for the GMC proposal doesn't really reflect the reality of frontline general practice.'

Dr John Hughes, secretary of Manchester LMC, said: ‘This has rather dubious wording. Work can be good for some patients but the GMC needs to recognise there is an appropriate time and an appropriate sort of work for some patients.

‘I'm wondering how much pressure the GMC has come under from the Government for this.'

The DWP said its submission had been drafted by Dame Carol Black, its work and health tsar, but was unable to provide a copy as Pulse went to press.

A DWP spokesperson said:

‘The Department of Work and Pensions is supportive in principal of helping people who can work, get back into work.'

Additional duties for doctors

New requirements included in draft Good Medical Practice guidance

• To encourage patients to stay in, or return to, work

• To consider patients' religious, spiritual and cultural history

• To act as a mentor to less experienced colleagues

• To take ‘prompt action' against basic failings in care

• To ensure you or a named colleague retains responsibility for patients' continuity of care

• An explicit duty to be competent in providing care and performing other professional roles

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

1 Attachment

Dear [P. Smith],

Please see attached response to your FoI request.

Kind regards,

DWP Central FoI Team

show quoted sections

Barry Almond left an annotation ()

Excuse me for answering a question if it has already been answered but that is exactly what happened to my friend , he went for an atos assesment for a first time claim and failed , he was then shown a letter by his gp telling him not to issue any more sicknotes. the whole thing is a disgrace.. And I myself am in appeal phase waiting for my date at the tribunal.
In my case I have several problems and have been signed fit for work.. My doctor disagrees and has said he will continue to supply me with notes indefinately.. so I suppose your relationship with the doctor is vital to your claims and you are correct the dwp is trying to poison the water between docs/patients. Shame on them .. and shame on us if we let them gat away with it.. good luck.

J Newman left an annotation ()

Odd how a somewhat vague but perfectly reasonable statement along the lines of SUITABLY DESIGNED work being SOME help to SOME people SOME of the time can be ‘spun’ into any work being beneficial to everyone without exception.

P. Smith left an annotation ()

Yes, as if work itself is a panacea or cure-all in itself!!! It beggars belief!

Frank Zola left an annotation ()

Update: ICO tells DWP to “stop” issuing the #ESA65B ‘fit-note’ letters
https://mrfrankzola.wordpress.com/2019/0...

ICO forces DWP to require claimant consent (“opt-in”) before #ESA65B ‘fit-note’ letters can be sent to GPs
https://mrfrankzola.wordpress.com/2019/0...

Frank Zola left an annotation ()

"we are now aiming to have the ESA1 and
ESA50 live from mid-August and can share copies with you once they have been published. "
https://www.whatdotheyknow.com/request/6...
21/7/20 update
https://mrfrankzola.wordpress.com/2020/0...