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Thousands of terminally ill patients risk being denied benefits, says RCGP



Thousands of terminally ill patients risk being denied benefits, thanks to a Government rule that says people can only claim if they have six months or less to live, the RCGP has said.

The college’s end-of-life lead is calling on the Government to review its rules around fast-tracking welfare support such as Personal Independence Payments and Universal Credit for people suffering from terminal illness.

Under the current rules, doctors must declare that a person has less than six months to live before welfare support is fast-tracked.

However, RCGP’s Marie Curie end-of-life lead Dr Catherine Millington-Sanders has said GPs and other doctors are unable to make such declarations, especially with advances in medical treatment.

To qualify for ‘Special Rules’, where welfare support such as Personal Independence Payments and Universal Credit is fast-tracked and paid at the highest rate, patients must meet the Government definition of terminal illness as a ‘progressive disease or health condition which means the person is not expected to live for more than six months.’

Doctors are required to sign a DS1500 form that states the patient’s life expectancy is under six months, but have argued it’s impossible to have ‘clinical certainty’ over prognoses.

Marie Curie and the Motor Neurone Disease Association are calling on the Government to reform this criteria.

The charities are due to present their 15,000-signature ‘Scrap six months’ petition to Downing Street next month. Last year, the MND’s survey of 1,001 GPs across the UK revealed that 51% of the GPs who took part said they would support this change.

Dr Millington-Sanders told Pulse: ‘In this era of advancing treatments in medicine, it’s more difficult to be able to tell a patient exactly when they are going to die.

‘However, we can be certain from a clinical perspective what the diagnosis is, how this impacts their life, and if they will benefit from support.

‘Having vulnerable and seriously ill people going in for work assessments is completely against the ethos that we GPs are there to support them through their terminal illness.

‘It’s frustrating from a GP’s perspective when we have to write in and say that we clinically disagree with a decision. The amount of time we can spend trying to get hold of people and then having to appeal not only adds to our already intense workload, but also prevents us from spending more time with patients who need us the most.

‘As a GP, you’re left with a feeling of upset, when for some people, this system doesn’t work and seems inequitable. There’s clearly a need for change.’

Scott Sinclair, head of policy and public affairs at Marie Curie, told Pulse: ‘GPs face pressure to talk about “six months” with their patients who are terminally ill, but we’re hearing that they don’t feel confident doing so. 

‘As well as it lacking a clinical basis, we’re concerned that being asked to predict how long a patient has left to live can damage the doctor-patient relationship, and makes GPs fear for the consequences on these patients.

‘We feel the situation would improve via a joined-up Government approach across the benefits system, with a team focusing solely on end-of-life care and bereavement support for families.’

Policy manager at the Motor Neurone Disease Association Alex Massey said : ‘We encourage GPs to support applications under the Special Rules for Terminal Illness, as it’s far more appropriate than the standard process for people living with MND.

‘We recognise this can be a difficult conversation needing to be handled sensitively. Awareness is vital, so GPs understand the challenges faced by terminally ill patients when claiming benefits and are able to support them effectively.’