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Independents' Day

Courts carry out review after study reveals GP evidence was factor in only 2.9% of disability benefits appeals

The Government has carried out an assessment of the key factors in deciding appeals against decisions to remove disability benefits from claimants, after a pilot study revealed GP evidence was the deciding factor in only 2.9% of cases, Pulse has learnt.

The Department of Work and Pensions asked judges to provide a written summary explaining their decisions in individuals’ appeals against the removal of the Employment Support Allowance, including the importance of the GP report.

It followed a study last November that showed judges cited GPs’ supporting evidence as the principal factor in only 2.9% of successful appeals when provided with a list of potential reasons from a drop-down menu.

GP leaders said that practitioners are increasingly being asked to provide evidence to support such appeals – which they say is increasing workload and causing problems with the doctor-patient relationship – despite these figures showing they are of relatively little importance in judges’ decisions.

The ‘Social Security and Child Support Tribunal hearings: Early analysis of appeals allowed from pilot data’ report was released in November 2012, and asked decision makers to select the primary factor affecting their judgement.

The study reviewed around 26,500 successful appeals relating to disability benefits between July and October 2012. Of these appeals 2,170 (8.2%) were overturned based on new documentary evidence, medical or otherwise, and GPs’ evidence was the main factor in 768 – 2.9% - of cases.

The most significant factor was new oral evidence, which was the primary reason given in 41.7% of successful appeals.

A DWP spokesperson told Pulse: ‘Building on this drop-down menu feedback, HM Courts and Tribunals Service agreed to the controlled start of an initiative for the Social Security and Child Support Tribunal to provide written summary reasons for their decisions on ESA appeals. The initiative started on 10 June, for 8-weeks at four hearing venues.  The exercise has improved feedback for our decision-makers.’

The spokesperson added that, at the appeals stage: ‘There is a wide range of evidence that can be used including evidence from the WCA and all the supporting medical evidence provided by the claimant, including that from GPs.’

But GP leaders warned that GP practices find themselves under increasing pressure to provide extra evidence above and beyond the initial assessments that the DWP requires.

Dr Robert Morley, executive secretary of Birmingham LMC, said that people seeking additional supporting evidence was a widespread and ‘increasing problem’.

He said: ‘It’s not just in my area, in all areas it’s an increasing problem. Part of the problem is that the letters given to appellants. Though they do not say “go and get a letter from your GP”, they say it may be helpful to your case if you get supporting medical evidence.’

‘Now straight away the one port of call for all patients will be to go to their GP. So it causes increased numbers of appointments, so obviously increased workload. If the GP doesn’t feel it’s appropriate to provide anything, then it can cause difficulties in the relationship between doctors and patients.’

‘It’s very difficult to get across to patients that it’s not going to make that much difference anyway because any medical evidence a GP has given will have been in the original report when the patient applied for the benefit in the first place. So there’s not a great deal more to add.’

Dr John Canning, chair of the GPC’s professional fees and regulation committee and a GP in Middlesbrough, said: ‘Only in a small number of appeals, is medical evidence actually the reason someone has won their appeal, the vast majority of appeals are won because of somebody’s capability. And the best way to show you’re incapable, at an appeal, is to turn up. There’s a sort of very basic logic in that.’

Dr Peter Holden, a GPC negotiator, said: ‘You are not required to produce evidence for anything, unless you are paid for it, except for the certificates that are in our terms of service. And preparing an appeal for a patient is not in it and it must stay out of it.’

‘My message to GPs is “do not do this”. You only have to respond to enquiries from DWP officials and their agents, there are proper systems for seeking your advice and those are the only ones you are able to use.’

Readers' comments (12)

  • I feel the low percentage reflects the lack of support from GP's overall. A GP factual report can be very important to a claimants appeal.
    There have to be some patients who GP's feel are worth helping with the appeal? Expecially in mental health cases where the health care professional who has "examined" the claimant for the purpose of the limited capability for work test, obviously has no understanding of that claimants mental health problem and how it affects their day to day life.
    I see people on a regular basis who have been refused ESA based on a perfunctory, at best, medical which has taken less than half an hour - how can this health professional possibly gather enough information about that person to acurately assess their mental health - they are getting a snapshot of that person only.
    It is these types of cases that most need GP (or other) support. It is invaluable.

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  • >I feel the low percentage reflects the lack of support from GP's overall.

    I think you'll find that the low percentage reflects the FACT that this work is not in the GP Contract and thus we personally incur both time and monetary costs for undertaking this work. This is one of the reasons that there are now many reports.

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  • that should be NOT many reports.

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  • I do reports called MED3

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  • I do TONNES of supporting lettters so there's certainly no lack of support for patient's from this GP thank you very much! Having said that if they only bother to look at 2.9% of my massively increased extra workload that is created by this - is there any point?!

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  • >is there any point?

    No - and that's the point. It's your choice if you wish to do them but I do hope you make it clear to patients that 1) it makes little difference and 2) this is a chargeable service.

    If you do them for free, again that's your choice, but you're essentially donating your time to charity (which is OK if you feel it to be worthy)

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  • A judge at a Tribunal will look at the evidence on both sides, including letters from doctors, a judge will then question the person thoroughly to ascertain if what evidence was provided is truthful/accurate against the finding in the WCA assessment process and make a decision.

    Many appeals are won due to the fact that the WCA assessments are often inaccurate and because the medical evidence provided was often ignored in the first place and the WCA often uses supposition and imaginary aids over science and medical facts.

    Though a Doctors letter may be secondary to the living testimony before them, it's still vital in a system where medical evidence and professional advice is ignored to the detriment of patients. The BMA does not support the WCA for good reason, it's flawed and abused, hence the high appeal rate and success of appeals at Tribunal level.

    The question is, would assisting, or refusing assistance to patients at this time be helpful or detrimental to their health?

    Doctors are put in a very difficult position because of a political agenda. It would be a hope that Doctors would support their patients well being over a politician's ill thought agenda.

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  • "‘My message to GPs is “do not do this”. You only have to respond to enquiries from DWP officials and their agents, there are proper systems for seeking your advice and those are the only ones you are able to use.’"

    The DWP does not use this system at all, with the full intention of harming a patient's case, which is the only reason a patient has to turn to their already overworked GP for extra help. The whole problem is that the system is unfairly loaded in favour of the DWP, where it should be neutrally driven and evidence based.

    You may not be aware since a DWP/ATOS contract ended, untrained DWP staff are currently Googling medical conditions and using this information when making decisions. This is how bad things have got.

    The GP's may be in a terribly difficult and challenging situation, but is that any worse than being sick, disabled or mentally ill person being reduced to living in poverty and huge amounts of stress when a system put in place to protect them is being abused.

    If you want to be a part of injustice and harm to often vulnerable patients, do nothing by all means.

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  • No mention of reports from hospital doctors?

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  • It certainly looks like a political agenda- where doctors are being punished with work and patients' disdain (both with political origins) further decreasing doctors' standing and their authority in the eyes of the nation.
    It's part of the Coalition's and Oposition's policy to trash the NHS for the benefit of private businesses: increase the chaos, reduce the funding and get media busy screaming about shabby health standards. All doctors, concerned about patients should ask, "How are our reps responding?"

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