PARTE B LINEAL

The pilot arrangements had been welcomed by GPs who saw opportunities for saving time and shedding an administrative chore, and a procedure likely to lead to a more balanced picture for benefits decisions, or at least no worse an assessment of their patient. GPs who had declined to take part had concerns about confidentiality, whether patients understood the implications of consenting to the procedure, and saw risks in loss of or damage to their records and not having continuous access in the surgery. Practices taking part in the pilot arrangements shared some of these concerns, but had resolved difficulties. Some had sought more information about how the records would be handled, and some had developed their own procedures to minimise practical risks or inconveniences. Practice managers were often of key importance in decisions made about participation in the pilot.

Not all GPs taking part had noticed any impact. Those who did were GPs practising on their own, GPs in areas of social disadvantage and those who tended to spend longer time in filling in the IB113 forms. The administrative and clerical staff with day-to-day responsibility for implementing the new arrangements had mixed views on the impact of the pilot. Practices sending actual records had found the process fairly quick and easy and no problems had arisen. In practices sending photocopied records and print-out from wholly computerised records, the additional work required was time- consuming and could be hard to fit into existing work schedules. As a result, it was not always possible to meet time requirements, and the payment was felt insufficient.

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There was some evidence that GPs whose strong negative views had led to non-participation, might view the pilot arrangements more favourably with greater understanding about how the records were handled. Concerns remained, however, about confidentiality and informed consent.

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3 Views and experiences of

incapacity benefits

claimants

This chapter presents views and experiences of the pilot arrangements of incapacity benefits claimants in the Sheffield and Rotherham area. The first two parts of the chapter explain what people understood about the pilot and why they decided to take part or not. Section 3.3 presents findings about people’s general awareness of, and interest in, the process of medical assessment. Section 3.4 explains how they felt about their GPs, what they thought their medical records contained, and views on medical examinations. This sets the context for discussion of perceived advantages and disadvantages of the pilot arrangements, the subject of Section 3.5. The last part of this chapter presents claimants’ overall views of the pilot. Appendix A explains the selection of the 32 claimants, whose views were sought for this part of the research, and provides a summary of their main characteristics. Twenty-two were recruited as participants in the pilot, and ten as non-participants.

3.1

Taking part in the pilot

The main source of information about the pilot was the DWP explanatory leaflet sent with the incapacity benefit claim form or the IB50 questionnaire. The leaflet included a telephone number for more information. People were given the option to opt out of the pilot by ticking a box on their claim form if they did not want DWP to have access to their case notes. People who submitted their claim form before the pilot started, and who were not required to fill in an IB50 questionnaire, were sent an explanatory letter (PEG1), and the opportunity to opt in.

3.1.1

Awareness of the pilot

Although incapacity benefits claimants were recruited to the research as pilot participants or non- participants, at the start of their research interview not everybody was aware of their relationship to the pilot. The letters inviting people to be interviewed and the researchers’ introductions served as reminders, but not everybody recruited as participants understood they were taking part and some recruited as non-participants believed their claim was being dealt with under new arrangements. Even after prompting there remained a small group of people who appeared to have no prior knowledge of the pilot arrangements, and were thus unable to discuss decisions about taking part.

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Those who remembered they were in some form of incapacity benefits ‘experiment’ knew that they had given permission. Not all such people could now remember what the pilot involved, but most who remembered giving permission thought they had understood at the time.

Some people remembered generally that the pilot was about medical records, or going further into their medical details. Non-participants retained less understanding about the pilot than people who had agreed to take part, as we might expect. Those people who had retained clear understanding that the new arrangements involved DWP looking directly at the medical records held by their GP included men and women in different age groups, and people recruited as new claimants and re-referrals.

3.1.2

Sources of information about the pilot

Few people could remember receiving a leaflet about the pilot; there were more frequent mentions of ‘a letter’. It was frustrating when the letter did not enclose the leaflet to which it referred, as some people reported.

Telephoning for more information had not worked well for those who had tried this. People who had sought information in this way said that staff seemed poorly informed. (We do not know whether such people used the advertised helpline or telephoned local DWP offices.)

Written information could be important; some people read this carefully and thought it was useful. Those who had clearest recollection of reading about the pilot and considering the new arrangements were existing claimants being re-referred for a PCA who agreed to take part. We might expect that some people who already had experience of the medical assessment procedures would be particularly interested in the idea that things might be done in different ways. Among the new claimants, not everybody who could remember receiving written information had looked at it carefully. Knowing their medical records would be used in the assessment for benefit could be all the information needed to decide whether to take part.

Those who remembered making a decision about taking part had known that participation was voluntary, although we see in the next section that some people thought refusal would attract attention. Nobody remembered giving thought to whether their GP was taking part in the pilot, but people were interested in this issue when the researcher raised it. There was some surprise that GPs could also choose whether to take part. Some people thought that if claimants wanted to take part in the new arrangements their GPs should be required to participate.