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Forum Home  →  Discussion  →  Work capability issues and ESA  →  Thread

‘Instructions ’ from DWP to GP Surgeries

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Mike Hughes
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I think my initial discomfort about reading such a phrase was driven by an instinctive feeling of “here we go again” as regards DWP dictating things they’ve no right to dictate. However, on reflection I’ve no issue with this as it’s an accurate reflection of how things should play out. It’s also aimed at the GP not the patient and uses the words “should not” rather than “must not”. Equally I remain unsure why GP evidence is a sensible thing to do.

What information should a PIP claimant request from their GP? A diagnosis? Prognosis? Medication? Treatments? All of those things are usually available to the claimant and provided they’re not in dispute then confirmation should not be needed. I generally err on the side of the social model of disability and think claim forms completed with 2 anecdotal examples per activity of incidents involving the claimants attempts to reliably perform a specific points scoring activity suffices in most cases

i.e. instead of “I fall a lot and have fallen recently” (which is assertion) you get

“I fell in my kitchen last Saturday; my left knee gave when I was walking across to the sink and I collapsed to the floor without warning and banged my head. I was badly cut but did not need hospital treatment. I was able to get up by myself using the furniture near me but this took 10 minutes; caused me considerable immediate pain which persisted for the remainder of the day and I would not have been able to get up at all had furniture not been near. This is because of the weakness I have in both ankles, knees and hips. I require leverage of some kind to get to my knees and then upwards.” (which is evidence).

I can’t honestly remember the last time I requested GP information. The 52% stat below suggests that what we want to be true about GP evidence and what is actually true about it are potentially miles apart.

Where a claimant lacks insight - e.g. LD or MH - then medical evidence is obviously helpful but more likely to be coming from a specialist or their GP records (and we all know where we’re up to with that one thanks to GDPR).

Where claimants obtain letters from GPs detailing their mobility and daily living needs it’s long been held that GPs are unlikely to be doing anything other than speculating on what they would generally expect of a claimant with condition x rather than detailing the specifics of the consequences of condition x for that person. That’s not medical evidence. It is evidence “with little probative value” as I was once told by a tribunal judge in fairly blunt term. “Arthritis is bad and therefore this claimant will be bad” is not great evidence.

To paraphrase an esteemed ex colleague “We would slaughter a tribunal assessing mobility based on what they see when a claimant enters a tribunal hearing. Why would we accept the word of a GP who has usually only seen the claimant walk in or out of a consultation? Equally, unless the GP is sleeping with the claimant what on earth could they contribute to a discussion of night time needs?”

According to case law a GP repeating what a claimant has told them can be evidence of their credibility being accepted but it’s not medical evidence as such. So, I’m not (and never have been) sure why GP evidence is critical to such claims.

Encouraging patients to believe that a PIP claim can only succeed with support from a GP is factually incorrect, although I’ve heard WROs do exactly that, and demonstrably so. DWPs last DLA stats suggested 52% of claims succeed without medical evidence. Indeed one of our biggest issues - the frustration of claimants who can’t believe their claim hasn’t succeeded given the support of their medical professionals - is perpetuated by encouraging a reliance on GP evidence etc. that most often simply adds nothing.

So, for me. No issue and potentially a good thing.

“Ducks” 😊

Pete at CAB
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Welfare Benefits Adviser’ for Citizens Advice Cornwall

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I agree with the points made, I too felt a certain discomfort about another attempt to ‘control’ what GPS do ( however mild and ineffectual) hence my post.
I wouldn’t suggest that every PIPS claim needs extra GP/ medical evidence but do feel that some claims are more likely to succeed/avoid an assessment if there is medical evidence from before the date of claim that (for example) the cl has been treated for injuries resulting from a fall on multiple occasions.

The other thing about asking for evidence is you may occasionally get a pleasant surprise. Some time ago I wrote to a GP about a patient’s mobility and the GP wrote back to say that although they had never formally assessed the distance the patient could walk the GP could see the practice car park from his window and he had often noticed the patient struggling to walk to the surgery door. This was in connection with an appeal which we then won easily.

ClairemHodgson
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also it may be a question about the diagnosed condition - the claimant can of course talk about the effects of the condition on the claimant, but the GP would be able to assist on whether what the claimant says is in fact a function of the condition or something completely different (or, if necessary, nothing wrong that would cause whatever it is); and for some conditions its helpful to provide proper evidence as to the condition, its effects etc etc etc particularly if the claimant cannot articulate all of that (and is not, of course, a medic….)

overall i think medical evidence and whether it is needed has to be a function of the particular case, but there’ll be a fair few where formal evidence is needed ....

tribunal medical member who hasn’t heard of whatever it is isn’t uncommon…..ditto hcp of course!

Stuart
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FOI response confirms that DWP is complying with ICO requests by amending ESA1, ESA50 and UC50 declaration to provide ‘opt-in’ consent before doctor can be informed about WCA outcome -

The consent wording included in the declaration sections on ESA forms is being revised and will be removed from the declaration. The content has been reviewed by a number of internal and external stakeholders and will be amended so applicants: can -

- give or refuse consent
- understand how their health information will be used
- know what will happen if they refuse consent, and are reassured that they can still claim the benefit if they do
- know how to change their mind later.

Forms ESA1, ESA50, and UC50 will be amended as soon as possible and we are working with suppliers and providers to agree a delivery timetable.

 

Jon (CANY)
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Welfare benefits - Craven CAB, North Yorkshire

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Stuart - 12 August 2019 09:44 AM

FOI response confirms that DWP is complying with ICO requests by amending ESA1, ESA50 and UC50 declaration to provide ‘opt-in’ consent before doctor can be informed about WCA outcome -

The consent wording included in the declaration sections on ESA forms is being revised and will be removed from the declaration. The content has been reviewed by a number of internal and external stakeholders and will be amended so applicants: can -

- give or refuse consent
- understand how their health information will be used
- know what will happen if they refuse consent, and are reassured that they can still claim the benefit if they do
- know how to change their mind later.

Forms ESA1, ESA50, and UC50 will be amended as soon as possible and we are working with suppliers and providers to agree a delivery timetable.

Is anyone aware, has there been any movement on this? As far as I can see, the downloadable PDFs of the forms have not been amended as yet to make consent opt-in.

Dan_Manville
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Mental health & welfare rights service - Wolverhampton City Council

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Jon (CHDCA) - 08 January 2020 12:24 PM

Is anyone aware, has there been any movement on this? As far as I can see, the downloadable PDFs of the forms have not been amended as yet to make consent opt-in.

They rowed back on it a few days after the policy had been firmed up by JCP. I doubt the forms were ever even printed.

Paul_Treloar_AgeUK
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Yep, absolutely shameless.

Tories remove disability and health data consent rights – on first day as new Gov.

[ Edited: 8 Jan 2020 at 03:56 pm by Paul_Treloar_AgeUK ]
Gareth Morgan
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Paul_Treloar_AgeUK - 08 January 2020 01:42 PM

Yep, absolutely shameless.

Tories remove disability and health data consent rights – on first day as new Gov.

That gives me “about:blank#blocked”

Jon (CANY)
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Welfare benefits - Craven CAB, North Yorkshire

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Think it’s meant to be this (which also includes a link to the briefly-available version of the ESA50 with consents)
https://mrfrankzola.wordpress.com/2019/12/17/data-consent-rights-removed/

Thanks all, this had passed me by.

Paul_Treloar_AgeUK
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Information and advice resources - Age UK

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Thanks Jon, don’t know what’s happened there. Yes that it was I linked to.

Eta: Ah, just checked and I forgot to put the link in. I blame the New Year…..

Jon (CANY)
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Welfare benefits - Craven CAB, North Yorkshire

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Jon (CHDCA) - 08 January 2020 12:24 PM
Stuart - 12 August 2019 09:44 AM

FOI response confirms that DWP is complying with ICO requests by amending ESA1, ESA50 and UC50 declaration to provide ‘opt-in’ consent before doctor can be informed about WCA outcome -

The consent wording included in the declaration sections on ESA forms is being revised and will be removed from the declaration. The content has been reviewed by a number of internal and external stakeholders and will be amended so applicants: can -

- give or refuse consent
- understand how their health information will be used
- know what will happen if they refuse consent, and are reassured that they can still claim the benefit if they do
- know how to change their mind later.

Forms ESA1, ESA50, and UC50 will be amended as soon as possible and we are working with suppliers and providers to agree a delivery timetable.

Is anyone aware, has there been any movement on this? As far as I can see, the downloadable PDFs of the forms have not been amended as yet to make consent opt-in.

The ESA1 and ESA50 were finally amended in August 2020 to include an opt-in consent.
The UC50 still says they will automatically inform your GP of the outcome, there is no way to opt out.

https://www.gov.uk/government/publications/employment-and-support-allowance-claim-form
https://www.gov.uk/government/publications/capability-for-work-questionnaire
https://www.gov.uk/government/publications/uc50-form-universal-credit-capability-for-work-questionnaire