Training occupational health professionals to do disability assessments

OH nurses are involved in disability assessments for PIP, a government scheme assessing the level of income support disabled people need. Fiona Colegrave, who is responsible for the service at outsourcing service Capita Health and Wellbeing, explains the role of OH. 

Since the assessments for Personal Independence Payments (PIP) began, Capita has made significant improvements across the service, by increasing the number of assessments carried out while constantly focusing on improving quality.

Our priority has always been to deliver assessments in a timely, fair and sensitive way, and to provide high-quality, robust, evidence-based reports to the Department for Work and Pensions (DWP).

What is PIP?

PIP is a government benefit helping people with the extra costs caused by long-term ill health or a disability. Individuals are assessed to identify the level of support they need. The assessments are carried out by outsourcing service Capita.

OH professionals play a key part in that. Coming from a role based on assessing functional ability, they are particularly qualified to conduct objective assessments by analysing how the claimant’s condition impacts upon their daily lives.

What is PIP?

Personal Independence Payment (PIP) is a government benefit helping people with the extra costs caused by long-term ill-health or a disability. Individuals are assessed to identify the level of support then need. The assessments are carried out by outsourcing service Capita.

This differs from “work functionality assessments” that provide advice to office managers on an individual’s ability to return to work, as disability assessors produce reports for the DWP on the difficulties experienced by a claimant in carrying out routine, daily tasks as a result of their impairment or disability.

As a disability assessor (DA), you are required to assess objectively how someone’s health conditions affect them and submit a report that is fair, reliable and can be justified with evidence because, if necessary, it may need to be scrutinised through an appeals process.

For these reasons, it is essential we equip DAs with the skills required to manage the assessment process, including: time management; questioning techniques; non-advocacy; collating all available evidence and identifying contradictions; and using an analytical but empathetic approach.

It is important for DAs to establish a rapport with the claimant, so that claimants feel like they have been able to express, in their own words, how their disability affects them and so they know that a DA will produce a report that accurately reflects their functional ability.

The assessment needs to take into account fluctuating conditions and the ability of an individual to carry out tasks reliably, which means: safely; repeatedly; to an acceptable standard; and in a timely manner.

Best practice and consistency in disability assessments

As no two assessments are identical, in our training and coaching we make sure that we emphasise the point that our DAs treat each claimant as an individual. We do not focus on the diagnosis of their condition but rather on the impact that their condition has on their daily life, taking into account possible comorbidities.

We offer training on clinical conditions, examination techniques, collecting robust evidence, selecting the correct descriptor as to the claimant’s level of ability in each of the 10 activities of daily living and two mobility activities, and report writing – all before a period of supervised practice.

No matter what your background and experience, you must be trained to Capita’s and the DWP’s quality standards, and achieve the DWP approval status. Capita’s training is a mix of face-to-face, at-home and online training, which trainee DAs (TDAs) find useful as they don’t need to be away from home for long periods of time.

Capita sets clear objectives and timelines in terms of training, on what needs to be achieved and by when, so TDAs can see what they are working towards and how they are progressing.

One of the most valuable parts of the training is the experience of carrying out a PIP assessment. Capita employs actors to play the role of the claimant so that assessors can do mock assessments. This provides an experience that is as close as possible to conducting an actual PIP assessment, and it is hugely beneficial in bringing the dayto-day role to life. Taking part in the mock situation gives assessors a lot of confidence but also guidance on how to approach assessments objectively.

There is then a final competency assessment before TDAs can progress from the training stage and into supervised practice. Post training, the TDAs have the support of the clinical coaches, who are approved DAs themselves.

Once trained, the DAs’ reports are audited to ensure they meet the DWP’s criteria. After this they are then approved by the chief medical adviser at DWP to work as fully fledged DAs. This provides an additional important dimension to an OH professional’s CV supported by the provision of a minimum of two days’ continuous professional development each year.

Listening to feedback

Capita is constantly reviewing feedback from DAs through our trainers, coaches and specialist health leads. Where appropriate, our training and/or assessment approach is changed accordingly. In some instances, such feedback has resulted in some changes being made by the DWP to their PIP Assessment Guide.

An example of this is in the mobility component of PIP. After reviewing the nature of the queries we were receiving from the DWP and our DAs, as well as assessing the feedback we received from our clinical audit team, the DWP updated its PIP Assessment Guide to include a more detailed explanation of how to apply the different descriptors, which has led to an increased accuracy in advising on level of function.

Capita’s approach to assessments is to put disabled people at the heart of its service; we welcome feedback from claimants and charities. As with anything new, there will always be some initial problems that will face some level of criticism and scrutiny, but from the feedback we have received from our assessors and claimants there is a general positivity about the work we do.

There were delays for claimants last year throughout the entire process, which has undeniably been difficult for them, but we have learnt from that and the situation has been completely resolved, supported by a strong focus on quality. We will continue working with disability organisations, local MPs and disabled people to constantly improve our service.

About Fiona Colegrave

Fiona Colegrave is chief medical adviser, clinical governance and training PIP at Capita.
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