This site is intended for health professionals only

At the heart of general practice since 1960

pulse june2020 80x101px
Read the latest issue online

GPs go forth

GPs struggle to cope with 21% rise in requests to verify work capability since January

Exclusive GPs are having to cope with rising levels of paperwork under the Government’s drive to reduce the benefits bill, with figures obtained by Pulse showing the number of requests to verify claimants’ ability to work have increased by over a fifth since the beginning of this year.

The figures show that the national crackdown on benefits has resulted in practices having to cope with increasing numbers of forms to support Employment Support Allowance (ESA) claims, which GPs say can take up to an hour of their time to fill out.

The figures obtained under the Freedom of Information Act show 136,000 ESA requests to medical professionals on behalf of the Government in the first three months of the year, the majority of which will be made to the patient’s GP.

This extrapolated across the whole year would total over 544,250 requests for the year - representing a 21% increase in ESA compared with the 448,800 requests made in 2012.

Requests for information from GPs have rocketed since ESA replaced incapacity benefit in 2008, when only 6,640 requests were made.

The GPC said it is meeting with the Department for Work and Pensions (DWP) to ensure that information requested by Atos Healthcare - which runs the DWP scheme - is more relevant.

The GPC also said that the ten calendar days GPs are given to supply further medical evidence for the claims is ‘not realistic’.

The DWP recently said it was planning to pilot a new approach to collecting information from claimants’ GPs, though a spokesperson could not confirm any details about the pilots the options ‘are still being considered’.

The Workplace Capability Assessments, which the Government uses to decides on whether people are eligible for the ESA, have also been criticised by the BMA, MPs and charities, as 38% of decisions are overturned at the appeal stage. Last year a committee of MPs said the assessments have a ‘disproportionate effect’ on the vulnerable.

Dr Nigel Watson, chief executive of Wessex LMCs said GP feedback into the process was important, but that the forms could take from 15 minutes to an hour and this was having a disproportionate impact on the time GPs could spend with patients.

He said: ‘We are spending more time on admin and paperwork and this is going to increase. With the increasing complexity of long term conditions, and patients working longer, not retiring at 60. Now the forms are more complex. It’s not only that you have more forms to fill in - its more complicated to fill in these forms.’

He added: ‘It adds to the other pressure that GPs are facing. If you spend more times filling in forms then you spend less time looking after patients - the time has to come from somewhere.’

Dr John Canning, chair of the GPC’s professional fees and regulation committee and a GP in Middlesbrough, said the GPC was currently holding talks with the DWP to ensure that GPs are only asked for information which was relevant.

He said: ‘We have been talking to DWP about making sure that when we get asked for information - is it relevant, and is it being asked at the right time?

‘It needs to be an appropriate request; we need to ensure that it achieves what it needs to for the department, as opposed to being a bureaucratic exercise. That balance is not right at the moment.’

He added: ‘The request to respond within a week is not realistic with the work we have to do. Many people work part time.’

It comes after the BMA urged ministers last month to ask GPs to provide factual information for every Work Capability Assessment to enable ‘better-informed decisions’ to be made about their patient’s eligibility for benefits.

The figures also come after the GPs were asked to fill out a new form determining whether patients are eligible for the Government’s new personal independence payment (PIP), a scheme - also run by Atos Healthcare - the GPC warned may ‘harass’ patients with a health condition or disability.

A spokesperson for Atos Healthcare said: ‘These figures should be viewed in the context of increasing numbers of assessments during changes to the welfare system. As agreed with the Department for Work and Pensions, we only proactively write out to GPs for further medical evidence where we believe that receiving it may mean we can avoid a face-to-face assessment for the most disabled and unwell. This leads to around 17% of claimants not needing to attend an assessment.’

A DWP spokesperson said they need the information to make decisions about an individual’s eligibility for the ESA: ‘It is important that we are able to make decisions on an individual’s benefit entitlements with accurate and up to date information, and sometimes this will require medical evidence from a claimant’s GP or other healthcare professional.

‘GPs have been clear that they do not want to be responsible for making decisions on peoples’ benefit entitlement, which is why we have processes in place to request the appropriate information from GPs to enable us to make those decisions.’

 

How ESA requests have risen

2008 - 6643
2009 - 159,225
2010 - 260,794
2011 - 311,533
2012 - 448,805
2013 (1st January- 31st March) - 136,064

Source: Freedom of Information request

 

 

 

 

Readers' comments (18)

  • Filling in the old IB113 or ESA forms is one thing; the real increase in work is patients being redirected to you by the voluntary sector for support letters/reports for their appeals, which you can decline or charge for. These still consume a lot of appointments, blocking other patients and are a system shift. They are also rising exponentially.

    Unsuitable or offensive? Report this comment

  • This comment has been deleted by the moderator

    Unsuitable or offensive? Report this comment

  • Andrew you have an obligation to report this transgression they are acting illegally

    Unsuitable or offensive? Report this comment

  • The galling thing is that ATOS takes absolutely NO notice of what we say even if we take an hour to fill them in correctly and compassionately for our most ill and vulnerable patients- I find it is the severely mentally ill that are suffering most with this. I hate politicians and ATOS!

    Unsuitable or offensive? Report this comment

  • re: Anonymous | 17 July 2013 9:52am @Andrew
    I think the charge isn't for the official form. Frequently when welfare advice organisations assist claimants, they advise patients to get a medical report to confirm their problems and for this to be attached to their appeal. This is private certificate/report which GPs can charge for. I tell patients to save their money, as GPs reports will largely be ignored - as according to the ATOS assessment pro forma, you may be ill or have a disability, but you are still able to undertake some form of work.

    Unsuitable or offensive? Report this comment

  • Completion of ESA 113 is definitely not chargeable to patients. Anyone doing so is in breech and should stop immediately. A major part of the difficulty is that it is filled in "without examination" on the basis of medical notes held for the purpose of diagnosis and treatment.
    Unsurprisingly these are not to the standard of a "functional assessment"I used to do DSS assessments for some years and it is a different skill set.
    The current contractor to the DSS are trying to obtain the information without an appropriate examination for the specific purpose.
    The statement to an individual declined benefit starts " on the basis of a written report from your doctor" but does NOT say the DSS made the call on the facts presented and is detrimental to the doctor patient relationship.

    Unsuitable or offensive? Report this comment

  • Hmm, what I am getting here is a mix of anger about workloads but some disappointingly unpleasant views as well.
    Its like this: those requesting your help to hold onto the pittance they receive will invariably be your most vulnerable and sick patients, the very one's who need your help most. They are 'resource hungry' it's true and with an ageing population and more people living longer with chronic health conditions this will not get any easier.

    I know it's easier to treat the 'worried well' but that is not what the job is about.

    If you don't help sick people hold onto the money they need then they will get sicker and bother you more: we all know 'poverty kills'.

    If there is a problem with the statutory requirements to provide medical information to support the DWP's decision making processes then take that up with the government, please do not take it out on your patients. If they are coming to you for help, it is because they HAVE to and they ARE your patients.

    The point about ATOS being paid to duplicate the work of GP's and other HCP's is well made. They are their to administer an essentially useless 'test', the WCA. Even Judges in Upper Tier Tribunals dealing with Appeals recognise this. Still, for this ATOS etc. are handsomely paid. That is how it is. The 'deep state' is committed to this model (as it once was to the 'Poor Law') because it is obsessed with outsourcing and, in this case because it does not trust either patients or GP's and other HCP's to give the answers it wants.

    Make no mistake, be in no doubt, the government has said time and again that 'helping people' is not the priority. Saving money and effecting a return to a pre 1945 vision of 'welfare' not social security, is it's intention.

    The NHS and GP's are on the front line and it is no accident that it is also now under sustained attack along with those who need it most. If people can be persuaded it doesn't work then it can be scrapped, bit by bit.

    It is hard to be empathetic and sympathetic when one is overworked, feeling under attack and 'unloved' yet GP's are relatively well paid, certainly in comparison to their sick patients struggling to survive on benefits. The problem is not your patients it is the system, one we must all work with.

    Unsuitable or offensive? Report this comment

  • The main problem is the complete failure of ATOS Healthcare to carryout a fair assessment that takes into account the medical evidence from GP's and in some cases consultants. These letters and case note are ignored by the health care professional employed by ATOS. I have cases where a consultant and GP's evidence was ignored in the ATOS report that was given to DWP and a five line report said the claimant was fit to work. This was turned around at appeal, as many others have been.

    Until ATOS and the DWP get their act together many more are going to go through the appeals system.

    I represent Military veterans who have been treated abominably by the ATOS / DWP assessment system. £68 million has been spent on the appeals process with nearly 40% being turned around.

    The veteran relies on the GP for support in this process.

    It would be better if the GPC told the DWP to sort out ATOS rather than make it even more difficult for veterans who are having a terrible time of it.

    Thanks for reading this.

    Tony Clatworthy
    The Veterans Party

    Unsuitable or offensive? Report this comment

View results 10 results per page20 results per page

Have your say