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BMA and RCGP deny approving changes to benefits letter

The BMA and RCGP have denied approving a letter telling GPs not to issue fit notes to patients who have been deemed fit for work by benefits assessors, but have admitted they may have seen it.

The Department for Work and Pensions came under fire last month for altering the wording of its ESA65B letter to GPs – and has now said it is ‘discussing a revised letter’ following GP concerns.

Charities warned at the time the altered letter meant patients appealing a benefits assesment could be at a financial loss while awaiting the outcome.

But the DWP claimed that ‘the wording of this letter was cleared by both the BMA and the RCGP’.

A committee of MPs that scrutinises the DWP has now released its recent correspondence with the BMA and RCGP, in which it asked whether they agreed to the letter.

Both organisations suggest they did not approve the rewording during a meeting with the DWP.

The BMA said it ‘does not have the authority to clear DWP policies’, while the RCGP said there was ‘some ambiguity about what was said’ at the meeting and it was ‘unable to provide further clarity’ about what took place because there is no record of what was discussed.

However the BMA had admitted it was ‘given sight’ of the letter, while the RCGP said the altered wording ‘may have been considered as part of wide-ranging meetings’.

Both organisations have since said they want to see the letter amended.

The BMA told the work and pensions committee: ‘At a meeting with the DWP and RCGP a BMA representative was given sight of the ESA65B amended letter. The BMA considers that sight of this letter was for the purposes of information sharing and did not agree or otherwise sign off the content of the letter.’

The RCGP said: ‘The college has sent representatives to stakeholder meetings with the DWP on a variety of topics, and we are aware that the [DWP] claims that “The British Medical Association and the Royal College of General Practitioners agreed to the revised wording of the ESA65B on 4 August 2016”.

‘However, there is some ambiguity about what was said in the referenced meeting with the DWP. Since the DWP did not keep any written records of what was said at this meeting, we are unable to provide further clarity. ‘

A spokesperson for the RCGP told Pulse: ‘The wording on the current ESA65B letter may have been considered as part of wide-ranging stakeholder meetings between the DWP, the college and others. It has since become clear that the wording has had unforeseen consequences and we would welcome plans to amend it.’

Dr Peter Holden, chair of the BMA’s professional fees committee, said: ‘BMA representatives attend meetings with the Department for Work and Pensions in an advisory capacity, and have done so for many years. However, our remit is not to sign-off or approve government policies.

‘We have long said that neither the Employment and Support Allowance (ESA) nor its predecessor processes are fit for purpose, and this letter is another example of doctors and patients having to work within the boundaries of an overly bureaucratic and obstructive system.’

He added: ‘For patients going through the process of applying for ESA and those subsequently appealing any decision, we recognise this is an incredibly distressing time.

‘If a patient is denied ESA but is in the process of appealing, their GP should continue to provide them with fit notes so they are able to continue receiving payments, and we have issued guidance to members just this week clarifying this.

‘We support a revision of the letter to ensure that both doctors and their patients are crystal clear of expectations, and we will continue to offer advice on its drafting.’

A spokesperson for the DWP said: ‘We have regular discussions with the BMA and RCGP to ensure we deliver effective support to disabled people and those with health conditions.

‘The wording of this letter was discussed as part of these meetings, as both organisations confirm, as was the release of the final letter. Of course we recognise the concerns of GPs which is why we are discussing a revised letter with the BMA and RCGP and have issued clear guidance for GPs in the meantime.’