Select Committee on Work and Pensions Minutes of Evidence


Table 1

Further memorandum submitted by the Department for Work and Pensions (MS 01A)

1.  INTRODUCTION

  1.1  This supplementary memorandum contains information to answer questions put to the Department, which was not to hand when the Department's Memorandum was submitted. It covers:

    —  Time taken for Incapacity Benefit examinations.

    —  Data on claimant complaints.

    —  Data on customer satisfaction surveys.

    —  Pay levels for sessional doctors and doctor shortages.

    —  Claimants turned away unseen.

2.  TIME TAKEN FOR EXAMINATIONS

  2.1  Improvements to service performance implemented by Medical Services have included a more flexible approach to arranging examination sessions, in the interests of both claimants and doctors. Previously, sessions were of a fixed duration of 3.5 hours; and were all held during normal working hours. Doctors are now free to contract for any period of time they choose. Additional evening and weekend sessions offer both doctors and claimants greater choice. The duration of sessions is variable, so it is no longer meaningful to express management information data in terms of average number of claimants seen per session.

  2.2  Time spent with claimants has not reduced, although improvements to scheduling have reduced time wasted between examinations. The average time taken for assessment over the last six months was 37 minutes, and represents the actual time spent by the doctor with the claimant, plus the time taken to write the report. The previously quoted figure of 46 minutes was calculated differently, by dividing the session duration by the number of claimants seen. As well as time spent with the claimant and completing the report, it also included the time taken to preview the case notes and collect the claimant from the waiting room, as well as time lost waiting for claimants to arrive. The success of the "Did Not Attend" project (see paragraph 6.11 of the main DWP memorandum) means that time lost at examination sessions will in future be minimised.

  2.3  The time required to carry out an appropriate assessment varies depending on the claimant's disabling condition and its complexity. Doctors are encouraged to take as much time as required to provide an accurate assessment. It is not in anyone's interest to unnecessarily prolong an assessment, or provide an unnecessarily detailed report.

3.  CLAIMANT COMPLAINTS

  3.1  Data on claimant complaints is not recorded by benefit type. Detailed information about the number and category of complaints for the last three quarters is at Annex 1. Prior to this, a different system of categorising complaints was used, so earlier data are not directly comparable.

  3.2  There has been a slight decrease in the overall number of complaints in the last quarter, and a steady decrease in the number of complaints alleging cultural insensitivity; the Select Committee had expressed particular concern over the latter category. All doctors now receive specific training in multicultural awareness; and any complaint alleging cultural insensitivity attracts immediate feedback to the doctor concerned, with retraining if appropriate. The ratio of complaints to examinations carried out remains well below 1 per cent.

  3.3  Actions taken to improve the complaints system include implementation of targets for timeliness of reply, and audit of the quality standard of replies by Medical Services.

4.  CUSTOMER SATISFACTION SURVEYS

  4.1  Regular customer satisfaction surveys are carried out. The results of customer satisfaction surveys over the last year are shown in Table 1.

PERCENTAGE OF CUSTOMERS EXPRESSING THEMSELVES SATISFIED OR VERY SATISFIED WITH MEDICAL SERVICES
Date

Examination centres

Domiciliary visits
February 2001

96%

96%
March

97%

95%
April

96%

93%
May

98%

95%
June

97%

89%
July

97%

94%
August

96%

95%
September

96%

97%
October

96%

91%
November

96%

95%
December

97%

94%
January 2002

96%

93%


  4.2  Customer satisfaction surveys include data on gender, age, ethnic origin, and special needs. Reports based on these parameters were produced between August and October 2000. However, due to the small numbers involved, the reports did not provide any additional information of value, and were therefore discontinued. The Department and Medical Services are further investigating the issue of research into customer satisfaction, to improve on the present process, including measures which will allow extraction of statistically valid data on these parameters.

5.  PAY LEVELS FOR SESSIONAL DOCTORS; DOCTOR SHORTAGES

  5.1  Sessional doctors' fees were increased by 3 per cent in September 2000, and by a further 15 per cent in April 2001. Since April 2001, fees for sessional doctors have been on a basis of fee per case instead of a fixed hourly rate. 96 per cent of existing sessional doctors opted to move onto fee per case; and all doctors recruited since April 2001 are contracted on a fee per case basis. When linked with the greater flexibility over session timing (see paragraph 2.1), the new arrangement offers doctors the opportunity to earn significantly more from this work if they want to.

  5.2  The new arrangement offers doctors greater flexibility on the time they wish to devote to this work. It also recognises and rewards productivity, for example, the doctor who sees an additional claimant, who might otherwise have had to be sent home unseen. Although the success of the "Did Not Attend" project will significantly reduce the need for overbooking, and hence the risk of claimants being sent home unseen, there will inevitably still be occasions where a doctor may need to see more than the planned number of claimants. Different levels of fee apply to case types of different complexity. There are also minimum income safeguards, guaranteeing levels of payment if not all the claimants expected turn up for examination.

  5.3  Safeguards are also in place to ensure that medical quality standards are maintained. Any sustained deviation from a doctor's normal pattern of working automatically triggers quality monitoring of the doctor's reports.

  5.4  Medical Services have lost a number of doctors through natural attrition. A major national recruitment campaign for both employed and sessional doctors has been under way since August 2001, with considerable success. 43 new doctors have already accepted an appointment as direct employees of SchlumbergerSema, and 28 of these have already started work. Allied to improvements in use of doctor time, such as more efficient scheduling of examinations, Medical Services have calculated that they have sufficient resources to handle current service levels, and anything up to a 10 per cent increase in current examination volumes.

  5.5  There remain areas where there is a general shortage of doctors. A number of initiatives have been taken to address this, including financial inducements to doctors recruited in these areas; and the use of a mobile task force of doctors to cover areas of shortage.

6.  CLAIMANTS TURNED AWAY UNSEEN

  6.1  The target that no more than 3 per cent of claimants should be sent home unseen was set in June 2001. Performance against that target is shown in Table 2.

Table 2

PERCENTAGE OF CLAIMANTS TURNED AWAY UNSEEN
Jun 01

July

Aug

Sep

Oct

Nov

Dec

Jan 02

Feb
4.46

4.04

3.76

3.53

3.68

3.19

3.18

3.75

3.61


  6.2  Although the target has not yet been met, there was steady improvement in performance until January 2002, when service levels slipped. Medical Services are predicting they will meet the target in March 2002. The success of the "Did Not Attend" project will enable more effective scheduling, reducing the need to overbook sessions to compensate for claimants failing to attend, and therefore reducing the need to turn claimants away unseen.

9 April 2002

Annex 1

COMPLAINT CATEGORIES FOR QUARTER ENDING AUGUST 2001

MSC/Categories
Doctor's
Manner
Content of
Exam
Length of
Exam
Clinical
Findings
Waiting
Times
Admin/
Accom
Others
ExpensesCultural
Insensitivity
No of
Complaints
Received
Southwest
Birmingham
101

70

7

34

5

24

2

2

1

93

Bristol
73

44

7

25

3

21

0

12

1

83

Cardiff
56

42

6

16

5

10

0

7

1

61

Total
230

156

20

75

13

55

2

21

3

237

South East
Nottingham
35

24

2

8

15

24

0

16

1

79

Sutton/Wembley
163

93

21

35

19

58

7

22

2

170

Total
198

117

23

43

34

82

7

38

3

249

Northern
Bootle
80

48

14

32

14

28

7

13

0

90

Edinburgh
20

11

1

3

0

5

1

7

0

29

Glasgow
47

33

12

34

13

26

1

5

0

77

Leeds
123

83

18

34

10

37

8

9

2

138

Manchester
41

30

6

24

2

10

3

15

0

75

Newcastle
79

66

6

26

25

46

4

12

1

141

Total
390

271

57

153

64

152

24

61

3

550

CRT
24

34

17

20

3

17

1

4

1

70

National Total
842

578

117

291

114

306

34

124

10

1106


  Notes:

  1.  A single complaint may cover more than one category

  2.  The National Customer Relations Team (CRT) handles a proportion of complaints directly

CATEGORIES OF COMPLAINT—QUARTER ENDING FEBRUARY 2002
MSC/Categories

Doctor's
Manner
Content of
Exam
Length of
Exam
Clinical
Findings
Waiting
Times
Admin/
Accom
Others ExpensesCultural
Insensitivity
No of
Complaints
Received
Southwest
Birmingham
76

60

9

26

3

26

5

6

0

79

Bristol
44

37

8

43

5

31

4

11

0

74

Cardiff
36

37

6

27

0

6

5

1

0

37

Total
156

134

23

96

8

63

14

18

0

190

South East
Nottingham
28

20

7

6

12

30

0

5

0

61

Sutton
83

71

12

26

22

34

1

5

2

102

Wembley
71

55

13

25

17

38

2

7

1

103

Total
182

146

32

57

51

102

3

17

3

266

Northern
Bootle
77

44

4

42

9

25

1

3

0

88

Edinburgh
22

8

8

12

7

9

0

3

0

42

Glasgow
41

30

9

25

9

19

4

2

1

69

Leeds
71

73

10

8

5

23

0

0

1

78

Manchester
33

19

5

12

8

39

0

4

0

85

Newcastle
44

25

5

17

48

82

0

11

0

168

Total
288

199

41

116

86

197

5

23

2

530

CRT
22

33

5

24

3

11

3

1

0

43

National Total
648

512

101

293

148

373

25

59

5

1029


CATEGORIES OF COMPLAINT—QUARTER ENDING NOVEMBER 2001
MSC/Categories Doctor's
Manner
Content of
Exam
Length of
Exam
Clinical
Findings
Waiting
Times
Admin/
Accom
Others Expenses Cultural
Insensitivity
No of
Complaints
Received
Southwest
Birmingham
91

52

10

30

2

46

2

5

0

115

Bristol
50

42

7

31

13

24

1

5

0

81

Cardiff
26

35

4

17

5

9

1

4

1

42

Total
167

129

21

78

20

79

4

14

1

238

South East
Nottingham
35

30

9

12

8

32

0

9

2

77

Sutton
123

64

10

14

12

36

0

12

2

130

Wembley
99

58

10

15

14

34

3

11

0

110

Total
257

152

29

41

34

102

3

32

4

317

Northern
Bootle
83

59

14

38

12

24

1

5

0

103

Edinburgh
26

17

5

10

3

5

0

3

0

34

Glasgow
60

30

8

29

5

26

0

6

1

76

Leeds
90

89

15

24

3

50

7

1

1

128

Manchester
41

31

6

27

4

11

0

10

0

78

Newcastle
72

47

9

19

21

55

0

5

0

116

Total
372

273

57

147

48

171

8

30

2

535

CRT
32

47

4

25

7

11

0

2

0

61

National Total
828

601

111

291

109

363

15

78

7

1151




 
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