Saturday, 1 October 2016

Health and Social Care Alliance Scotland (the ALLIANCE) Response:Consultation on Social Security in Scotland 28 October 2016


Health and Social Care Alliance Scotland (the ALLIANCE)
Response: Consultation on Social Security in Scotland
28 October 2016


The Health and Social Care Alliance Scotland (the ALLIANCE) is the national third sector intermediary for a range of health and social care organisations.  It brings together over 1,700 members, including a large network of national and local third sector organisations, associates in the statutory and private sectors and individuals.

The ALLIANCE’s vision is for a Scotland where people of all ages who are disabled or living with long term conditions, and unpaid carers, have a strong voice and enjoy their right to live well, as equal and active citizens, free from discrimination, with support and services that put them at the centre.

This response is closely informed by our members.  During the consultation period the ALLIANCE producedtwo surveys for members to offer their views on the underpinning principles of a new Scottish social security system and the delivery, advice and support attached to a new system.  We also hosted a consultation event which was also attended by the Minister for Social Security on 28 September 2016.  

Additional information is also drawn from the detailed interviews and evaluation undertaken of the Welfare Advocacy Support Project, an ALLIANCE and Scottish Independent Advocacy Alliance (SIAA) project funded by the Scottish Government to deliver a pilot advocacy support in four areas of Scotland (Dundee City, Forth Valley, Glasgow, Midlothian/City of Edinburgh) from May 2015 to October 2016.  The project was specifically tailored to support people with mental health problems, neurological conditions and learning disabilities.  Over 900 people used the project.

1. Fixing the Principles in Legislation

Which way do you think principles should be embedded in the legislation?
A) As a “Claimant Charter
B) Placing principles in legislation? 
C) Some other way, please specify

ALLIANCE members expressed support for the creation of a claimant charter as well as placing the principles in legislation.

The Claimant charter could be a useful way of ensuring that the stated principles of the social security system are well understood, both by people using the system and those administering it.  It is imperative that any charter is built upon active and constructive dialogue with people who use the social security system, co-producing and creating a discourse which encourages respect and dignity within a human rights-based framework.   This should include a process of consideration of what happens where people both using and administering the system do not meet the standards of the claimants’ charter.

The principles should be set in legislation which allows for procedures to take action if principles have not been directly met.  Our members have expressed the view that legislation is the most secure long term option – “so that future Governments cannot change it easily”.  Principles to be included in any future legislation should be developed in co-production with people who use social security systems and organisations that represent them.  Principles should build on the existing Scottish Government principles and make reference to:

• Dignity
• Respect
• Transparency
• Active and constructive participation of people who use the system
• Safeguarding wellbeing of people who use the system
• Continuous improvement.

The right to social security is recognised in both Article 22 of the International Declaration of Human Rights and Article 9 of the International Covenant of Economic, Social and Cultural Rights. These provide not only an accountability and legal structure to the application of these rights, but a set of desired key elements, around which any new social security systems should be built.  The Committee on Economic, Social and Cultural Rights have articulated the key elements as being:

• Availability – to ensure that benefits are provided for the relevant social risks and contingencies
• Adequacy – both in amount and duration in order that everyone may realise his or her rights to family protection and assistance
• Affordability – contributions (where required) should be stipulated in advance and must be affordable to all
• Accessibility – covering all persons without discrimination (including physical access).

These principles should not just be stated in the legislation but also embedded in the spirit of the legislation and how it is implemented.  Some members have questioned how previous legislative processes, which have included principles on the face of legislation, have then been held up against those principles (e.g. Social Care (Self-Directed Support) Act 2013 and Public Bodies (Joint Working) (Scotland) Act 2014).  This must include a detailed process of consultation with people who use the system, considering their experiences, and building on the principle of continuous improvement and transparency.  As such, we believe that a timetable of close consideration of the long term success, or otherwise, of the social security agency in meeting the principles set in the legislationshould be established.  

Both a claimants charter and the principles should exist alongside an “assessors charter” which sets principles for how assessment processes are carried out which is open, accessible and transparent for people going through the system to access.

2. Outcomes and the user experience

How can the Scottish social security system ensure all social security communications are designed with dignity and respect at their core?

Many of the people who used the Welfare Support Advocacy Project, found that the information contained in decision letters they received from the DWP about existing benefit decisions was not easily understood.  Advocates often needed to explain what the letter meant and the thinking behind it, and clarify basic practical matters such as the period that will elapse before they are called for reassessment.
We would urge the Scottish Government to ensure that accessible information must be provided, at all stages of the process, in a format that suits the individual’s long term condition/disability (e.g. easy read, braille, large print). This must be provided both before and after the assessment.

With whom should the Scottish Government consult, in order to ensure that the use of language for social security in Scotland is accessible and appropriate?

Any new system should take a more positive approach to the public conversation about the welfare system and how it supports the independence of people who live with long term conditions.  They must be centrally involved in shaping the language used and the tone of the assessment and how it is led.  A truly co-produced system would allow for people to share their experiences of the current system; what works and the drawbacks; and participate in a co-production process to plan the policy and design of the future assessment process.  

What are your views on how the Scottish Government can ensure that a Scottish social security system is designed with users using a co-production and co-design approach?

Co-production offers an approach to service design and delivery that makes the best use of the capacities of all stakeholders to jointly create effective solutions to complex and intractable problems.  Given that it can provide these solutions, it is therefore not something to be considered as nice to have’, but key driver of reform and improvement across the public sector. 
Case Study: Gaun Yersel

The Self Management Strategy for Scotland, Gaun Yersel, brought co-production to life. The Strategy itself was written by people living with long term conditions and their unpaid carers, and focused on the principles which support effective self management. 

The Strategy has been implemented through partnership work led by the ALLIANCE including the Self Management Fund for Scotland which has encouraged and supported a range of asset-based, co-produced self management initiatives and approaches to flourish in partnership, led by people living with long term conditions in their design, delivery and evaluation

In order to ensure that co-production happens in a meaningful and active way it must be inherent in the process throughout, not just at the design stage.  This must involve:

• A co-design process such as assessment processes for new disability benefits
• Co-assessment and evaluation of the new social security system which allows for continual improvement

Co-production, however, is not an easy solution and does come with a series of challenges.  In the development of its upcoming workplan the Scottish Government and people involved will need to address a series of issues in order to make the co-production process meaningful and effective.  For example:
• Co-production takes time 
• There are often cultural barriers and fears about thesharing of powernew ways of working and shared decision making
• Existing staff capacity and skills for facilitating co-production are often insufficient and staff can therefore lack confidence or ‘know how’
• This is often also reflected in service user skills/capacity for co-production.  People need support to co-produce and much of this is provided most effectively through peer support/third sector and can require some investments

These are not insurmountable, but they are challenges that will take thought and consideration to work through.

3. Delivering Social Security in Scotland

Should the social security agency administer all social security benefits in
Scotland?

Yes No

Please explain you answer.

As we noted in our response to the Smith Commission, disabled people, people who live with long term conditions and unpaid carers often experience the impact of a disjointed and complex welfare benefits system. Our members expressed concern that this would be exacerbated by a welfare system that is managed by different agencies (e.g. different administrations/partially devolved).

We welcome the creation of a new Scottish Social Security Agency, but caution the Scottish Government on the potential to introduce further complexities to the social security system and create interdependencies which will have to be carefully managed to avoid a more inaccessible system for people who use support and services.

Delivering social security through a single national agency has a series of advantages:

• Promoting consistency and uniformity (in both front facing assessment processes but also back office functions such as training, HR, IT etc.)
• Minimum standards can be established
• Reduce the opportunity for communication issues between agencies
• Allow for specialist expertise to develop, particularly in relation to communications.

Should the social security agency in Scotland be responsible for providing
benefits in cash only or offer a choice of goods and cash?

Yes No

Please explain you answer.

The ALLIANCE believes that the default position should be that all disability benefits should be made in cash rather than alternative support (excluding where this may apply to Motability arrangements).  Any potential “in-kind” support should be offered to the person by way of free choice, without pressure placed on the claimant to select the form of support most cost effective to the Scottish Government.  

Consideration should also be given to the impact of “in kind” payments for passported benefits and social care charging policies (where these apply).    

How best can we harness digital services for social security delivery in
Scotland?
Digital solutions, including the ALLIANCE’s ALISS programme, can provide significant support to people across local communities who have access with the social security system, employability support and a range of health and social care services.  

A Local Information System for Scotland (ALISS) 
Funded by the Scottish Government and delivered by the ALLIANCEALISS is an index of local sources of health and wellbeing support that may include not only traditional health and social care services but also local assets such as walks, cafes, activities and events – the sorts of things that people with long term conditions have identified as being important to their health and wellbeing.  ALISS can support people with both signposting to and accessing health and wellbeing support and also sharing knowledge of helpful support in local communities.


There may also be opportunity for the new social security agency to consider how it can better utilise data collected through digital services to effectively target and allocate resources and help align service delivery models with identified local needs and strategic priorities.

Should social security in Scotland make some provision for face to face contact?

Yes No

Please explain you answer.

As part of the Welfare Advocacy Support Project, and to stimulate further reflection on people’s experiences of PIP, people were asked what they would change about the benefit and assessment process that they had been through.  
Two broad categories of response emerged.  Between a quarter and a third of those asked wanted to see the face to face assessment scrapped entirely, or scrapped for particular groups of claimants. The remainder felt the assessment was necessary and/ or fair, with a minority of this second group suggesting it was an important opportunity for applicants. Further detail on these findings is included in our response to Part 6 of the consultation on disability benefits.

5. Independent Advice and Scrutiny

Do you think that there is a need for an independent body to be set up to scrutinise Scottish social security arrangements? 

Yes No 

Please explain your answer.

An overwhelming number of respondents to our surveysstated their view that a new, independent organisation would be their preferred outcome.  We agree with the briefing produced by the Child Poverty Action Group which highlights the significant value in having an independent, statutory body with a role that includes:
• Mandatory scrutiny of social security regulations
• Informal scrutiny of other regulations where there is an overlap between another policy area and social security
• Providing advice and assistance to Ministers.

We believe, however, that there is also a critical role for the creation of a separate function that oversees standards (particularly in assessment processes).  Crucially it must allow for a critical eye to be taken in relation to the social security system in Scotland – whilst also building on the concepts of fairness, transparency and respect.  Some of our members expressed their lack of trust in existing organisations overseeing the social security process and identified the creation of a new system as having the potential to create trust.  

The creation of a new organisation, as opposed to an existing organisation, would also allow for a new culture to be fostered which can be built around the stated principles of the new social security system.  This should also be underpinned by a panel of people who use the social security system to allow for effective scrutiny.

6. Disability Benefits

What is right with PIP? What is wrong with PIP?

Some referral partners of the Welfare Advocacy Support Project have identified that PIP roll out has not proved to have the detrimental impact on decisions that had been 
expected, whilst others identify major issues.  Some of the recurring issues identified include:

• Reduction in the care with which PIP decisions are made, with assessments seemingly done mechanically, and poor quality, general explanations given of the reasons for a determination 
• PIP assessors often seem to lack real understanding of mental health issues. 
• Demand for support with PIP is growing and in the meantime some people are being called for reassessments which appear to be resulting in a worseoutcome for people even if their condition has not changed. 
• On occasion, the ability to converse with the advocate is inappropriately being used by decision makers as evidence that the person can talk to anyone. 
• The transition from DLA to PIP has seen some people lose access to Motability cars as they lose mobility higher rate, whilst others gain as they move from DLA lower rate care, to PIP daily living at standard or enhanced rate. 
• The Mandatory Reconsideration process is viewed by many people as a mechanism for discouraging appeals, with success rates proving low, and the introduction of more delay into the system. Appeals remain formal and off-putting. 
• There may be a growing reluctance to offer assessments in the person’s home.
• There has been a growth for advice agencies in the amount of supersession work that they undertake, particularly in relation to people seeking to move from the Work Related Activity Group to the Support Group. 

The ALLIANCE remains concerned about the negative health impact our members have described to us of having been called for both/either a PIP and ESA face to face assessment.  Whilst we acknowledge that ESA is not in the scope of this consultation, it will remain a factor in many people’s experience of accessing the social security system following the devolution of PIP.  

• For some people, particularly those with mental health problems, the process itself of being assessed for any social security benefit is deeply stressful.  
• For those receiving a negative decision, the feeling of being disbelieved in relation to health problems may be a serious source of stress.
• Any increase in stress may inhibit the ability of people to manage their health issues effectively.
• Income poverty and debt are already significant features of the lives of many people who are disabled or living with long term conditions and further loss of income can significantly exacerbate existing physical or mental health conditions, or result in additional health issues. 
• Both DLA and PIP make an essential contribution to the ability of some disabled people to remain in work – they are not out of work benefitsAn unsuccessful claim for DLA may mean that applicants are forced to give up employment.  This is exacerbated for many by tightening eligibility criteria and increased charges for social care services, leading to reduced support and increased personal cost to disabled people.

PIP assessments take place in a context in which applicants do not necessarily fully understand the criteria on which they are being assessed, or the particular significance of the answers they give.

How should the new Scottish social security system operate in terms of:

• A person applying for a disability related benefit 
• The eligibility criteria set for disability related benefits 
• The assessment/consideration of the application and the person’s disability and/or health condition 
• The provision of entitlements and awards (at present cash payments and the option of the Motability Scheme) 
• The review and appeal process where a person isn’t content with the outcome

As part of the Welfare Advocacy Support Project, and to stimulate further reflection on people’s experiences of PIP, people were asked what they would change about the benefit and assessment process that they had been through.  
Two broad categories of response emerged.  Between a quarter and a third of those asked wanted to see the face to face assessment scrapped entirely, or scrapped for particular groups of claimants. The remainder felt the assessment was necessary and/ or fair, with a minority of this second group suggesting it was an important opportunity for applicants. 

People in the second group were, without exception, clear that the assessment process still needed to change significantly. The changes that they identified generally echoed the factors that led those who wanted the assessment scrapped to hold that view. 

On balance, the ALLIANCE agrees that face-to-face assessment, alongside the opportunity for home visit and paper based application, still has a role to play but requires significant reform if it is to fit the new social security landscape and aspirations.

Reform of the PIP face to face assessment 

As indicated above, the majority of Welfare Advocacy Support Project respondents felt that face to face assessments were fair. However, without exception this was qualified by the identification of changes that were seen as needed if fairness was to be achieved. 

Face to Face assessments were seen by many people as necessary to make sure that sure that people did not receive benefits to which they were not entitled.  This sense of the assessments being necessary could be shared by people whose experience of the assessment was quite negative.  

Some people saw face to face assessments as an opportunity for the assessor to pick up additional information, and thus an opportunity for the claimant as well, in part because there were things that couldn’t be explained in a paper form.  

Suggestions for Changes to the Assessment
Our members have made a range of suggestions for improving the face to face assessment, and other parts of the process.  Several people were clear that the process should be amended to ensure that the information collected within the assessment was genuinely additional:

‘You shouldn’t have to answer stuff that’s already on the form.  There is specific medical information on the form and you are being asked again about that. It’s not appropriate, it’s not necessary, it’s a waste of time….. They ask technical things, why are they asking when it’s in the paperwork. It seems that they are trying to catch you out, it [the repetition] is part of what makes it seem like that. Why ask again?’ Sandra, 49, Carer, Midlothian

Other people suggested

• Assessors did more research into cases before assessments, to make them less onerous.
• That the process could be made more genuinely user friendly, through a less formal approach, more assessments in people’s homes, improved customer service (particular through contact with telephone centres).
• Some people focused recommendations on the need to focus a greater proportion of the questions on mental health. 
• Reducing the length of time taken to complete the whole process in order to reduce stress.  Some people said that thirteen weeks was too long to wait and that results should be produced within a couple of weeks.
• Some people felt that a more joined up system would mean the assessors seeking out key information for themselves, for example, researching individual’s medical history and connecting with assessment and eligibility for other types of support e.g. blue badge, social care etc.

Qualifications of Staff

The most frequent suggestions for changes related to the need for those delivering the assessment to be properly qualified to do so.

‘There are changes I would make to the system. It should be people who know about disability and mental health that do the test. I don’t want someone who has just done a course, and is asking questions about whether you can reach something or put your arms out from your side.’ Andrew, 43, Falkirk


There was particular concern that the assessment should not be done by physiotherapists who were seen as lacking a full understanding of the conditions with which people were presenting.  There was also concern that staff without sufficient qualifications would not understand how conditions fluctuate.  

‘I’d change the system so that it was done by a doctor. The woman [who assessed her] probably didn’t even understand what the symptoms were. Every day is different for me, I can be OK for a few days and then not.Kirsty, 52, Dundee


Interaction between PIP and Social Care

Many social care services rely on contributions from the people who receive them, often through receipt of DLA or PIP.  In the fiscal year 2009-10 local authority income from charges for social care services was £228m.  Income for “non-residential services” amounted to £42.6m; 3% of the £3.6b gross expenditure on social care in Scotland.  A reduction in “the cost and caseload” of DLA in the creation of the Personal Independence Payment would threaten the viability of these services to continue in the traditional way.  As part of the new process, the Scottish Government will need to consider the impact for social care of changing eligibility criteria.

What evidence and information, if any, should be required to support an application for a Scottish benefit? 

A number of people who accessed the Welfare Advocacy Support Project felt that the information provided on application forms, by GPs and other medical professionals should be enough for a judgement to be made, with some suggesting that “they got nothing from my interview that wasn’t there in the medical notes.”

Some people felt that a more joined up system would mean the assessors seeking out key information for themselves, for example, researching individual’s medical history and connecting assessment and eligibility for other types of support e.g. blue badge, social care etc.

One person made this point in a particular way, stressing that the assessors could simply not understand his condition in the same way as people familiar with his case who had been working with him for years:

‘They should contact the doctors. My GP knows my background better than anybody, certainly better than someone who’s seen me at a 20 minute assessment. You feel as if you have to sell yourself and convince them of your problems, but a GP knows what those problems are.’ George, 60, Falkirk


Should the individual be asked to give their consent (Note: consent must be freely given, specific and informed) to allow access to their personal information, including medical records, in the interests of simplifying and speeding up the application process and/or reducing the need for appeals due to lack of evidence? 

Yes No

In health and social care, the sharing of personal data for research and clinical purposes has been a highly controversial issue.  Our members, however, often reiterate their view that the sharing of information about them by organisations involved in their care and support would be of significant benefit in reducing bureaucracy and the need to explain your conditions, symptoms or level of independence to numerous different clinicians, assessors or other parties.  

Systems, however, at present are not built around people who can or want to own the data that health and social care systems hold on them, rather they are built around those who can’t or don’t want to be.  Confidentiality remains a concern, but in our view the person themselves is the best guardian of their data and the level of sharing needs to be a decision based on the individual view of the person themselves.

Therefore the new social security system should be flexible enough to enable the individual to give consent to open up access to their data to whatever level stipulated by the individual.

If the individual has given their permission, should a Scottish social security agency be able to request information on their behalf? 

Yes No

If no, please explain why

As stated above, the new social security system should be flexible enough to enable people to give consent to open up access to their data to whatever level they stipulate.

Do you think people should be offered the choice of some of their benefit being given to provide alternative support, such as reduced energy tariffs or adaptations to their homes? 

Yes No 

Please explain why 

The ALLIANCE believes that the default position should be that all disability benefits should be made in cash rather than alternative support (excluding where this may apply to Motability arrangements).  Any potential “in-kind” support should be offered to the person by way of free choice, without pressure placed on the claimant to select the form of support most cost effective to the Scottish Government.  

Consideration should also be given to the impact of “in kind” payments for passported benefits and social care charging policies (where these apply).    

How could disability benefits work more effectively with other services at national and local level assuming that legislation allows for this e.g. with health and social care, professionals supporting families with a disabled child. How do you think this might be achieved? What are the risks?

Many social care services rely on contributions from the people who receive them, often through receipt of welfare benefits such as Disability Living Allowance (DLA).  In the fiscal year 2009-10 local authority income from charges for social care services was £228m. Income for “non-residential services” amounted to £42.6m; 3% of the £3.6b gross expenditure on social care in Scotland.  
To improve the integration of benefits and the social care system, the ALLIANCE believes that:

• Disability related benefits should no longer required to contribute to the cost of social care. The ALLIANCE opposes charging disabled people for care received from the state. Disability Living Allowance and Personal Independence Payment are intended to meet costs of socially constructed barriers to inclusion. However, evidence from demonstrates that charges have had a negative impact on their ability to seek or keep work. We believe that removing the ability of social services to charge for social care based on DLA/PIP income will increase people’s independence.
• There should be a longer period between re-assessments of Personal Independence Payments for individuals, for whom their condition implying life-long personal or practical support – or the removal of the reassessment process where this is appropriate.
• An individual’s request for assessment for either disability/carer benefits or social care support should trigger proactive engagement from the other agencies, e.g. local authorities or the new social security agency.

7. Carer’s Allowance

Do you agree with the Scottish Governments overall approach to developing a Scottish Carers Benefit? 

Yes No

Please explain why

The ALLIANCE supports the proposal to develop a Scottish Carer’s Benefit.  In doing so, we encourage the Scottish Government to consider the following:

• The removal of the 21 hour study rule, which means that carers (including young carers aged 16-17) must choose between education and caring. This would be in keeping with the aspiration set out in the consultation document that “being a carer should not be a barrier to education and training, employment or personal development.”
• The removal of the earnings limit for Carers Allowance or ensuring that it is uprated to take account of increases to the National Minimum Wage.  The limit (and its ‘cliff edge’ nature) gives little flexibility to carers who wish to work a few extra hours on a particular week ,as any financial benefit is likely to be lost due to Carers Allowance being cut completely.
• Allowing people to claim a greater amount of Carers Allowance if caring for more than one person. At present, there are many situations where carers are caring for two or more disabled people can only receive one payment of Carers Allowance.  This is despite the fact that caring for more than one person is more expensive, and carers who are caring for multiple people are less likely to be able to work outside of their caring role.
• Removal of overlapping benefit rules, which prevent other benefits from being paid, or paid at a lower amount, alongside Carers Allowance.

In particular, we encourage the Scottish Government to consider replacing Carers Allowance with a two-tier benefit for carers, as advocated for by the National Carer Organisations (NCOs).

• The first tier might be a Carers Allowance equivalent, paid at the same rate as Jobseekers Allowance, with the opportunity to earn small amounts in a paid job in line with the permitted earnings rule.
• The second tier could be a premium payment available to all carers in intensive caring roles (35 hours or more each week, as Carers Allowance is now) but payable to all qualifying carers, including those over state pension age, to compensate them for the additional costs of caring and/or to enable them to buy in help, goods or services to ease their caring situation.  This could be set at approximately the same level as other similar payments in the UK such as child benefit, i.esomewhere between £25 and £50 per week.

12. Job Grant

What should the Scottish Government consider in developing the Job Grant?
We welcome attempts to address and tackle youth unemployment through the new social security system.  However, a legal right to support would be preferred over any discretionary fund. 

The Scottish Government should also consider that:

• People who have been unemployed for long period of time all find the transition into employment daunting and costly.  This is true of all age groups, people from low incomes and those living with long term conditions, and it is unfortunate that is just specific to young people
• Many people may struggle to afford appropriate interview clothes and travel to interviews.  The Scottish Government should clarify if the fund is available before or after job offer been made?
• Access to Work is already available to people but is underused.  The Scottish Government should consider how this can be further promoted in conjunction with the new system.

13. Universal Credit flexibilities and housing element

Should the choice of managed payments of rent be extended to private sector landlords in the future? 

Yes No

Please explain why

Many people who live with long term conditions already live in poverty or close to the poverty line. 60% of households containing at least one person who is disabled or who lives with a long term condition have an annual income of £15,000 or lower. Not only do they experience higher levels of unemployment, those that are in work are also more likely to occupy lower-status, less secure jobs.  

In principle, this development should be a positive move, ensuring that the choice of direct payment is extended to a larger group of people.  Given that the private sector is less regulated than the social rented sector, however, safeguards need to be put in place to make sure tenants are not pressured into direct payment by a landlord.

Should payments of Universal Credit be split between members of a household? 

Yes No

Please explain why

The Scottish Government should use its new social security powers to split Universal Credit payments between claimants.  As has been widely expressed by the Child Poverty Action Group, Engender and others, single payments to one person within a household risks “exacerbating existing power imbalances” particularly those drawn along gender lines.  These policy changes would enable protect women’s access to their own benefits whilst also having a measurable impact on women’s income and on child poverty.

14. Advice, representation and advocacy

How could the transfer of the devolved benefits to Scotland be used to drive improvements in the provision of publicly funded advice?

The creation of a new system is likely to increase demand for information and advice, with demand on both statutory sector organisations and third sector organisations.  This has the potential to create a level of confusion and uncertainty, both for people who use the social security system and those who advise.  Our members have identified the following priorities as helping to improve the advice that people receive:

• Direct contact between the claimant and the office dealing with the claim
• Positive attitude and discussion between staff and people using the system
• Accessible information freely available online and through third sector organisations, providers of health and social care services, local authorities, the Scottish Government and other bodies with connection to disabled people, people with long term conditions and unpaid carers.
• Greater understanding of how passport benefits (e.g. blue badge and carers’ allowance) are available and how to access them.
• Positive links between the different advice services and providers of health and social care services.
• Proactive contact with people who are eligible for social security support rather than waiting for people to come forward.

There is likely to be increased demand for information and advice as new benefits are introduced and existing entitlements altered. The additional complexity of interactions between benefits and between social security systems risks creating confusion for people using the system. There may also be a risk of increased overpayment as people do not realise they have to inform both Scottish and UK institutions of a change in their circumstances. All these factors could increase demand on advice services who may struggle to cope in the absence of additional resources. 
There is also an opportunity to make improvements in claimant’s access to information and advice.  The Scottish Parliament could, for instance, legislate to include a right to access benefits information and advice to all claimants under the Social Security (Scotland) Bill. Access to that advice and support could then – as far as possible – be embedded within the framework of benefit delivery in Scotland, with active referrals to independent sources of advice being offered at various steps in the claimant journey. 

Balancing these new demands on advice services are the opportunities to improve and simplify benefit delivery and reduce the error, maladministration and high number of appeals that currently put pressure on advice services. 

Do you think that Independent Advocacy services should be available to help people successfully claim appropriate benefits? 

Yes No

Please explain why 

This proposal has received widespread support from our members, many of whom believe it should be available to be accessed by anyone who is asked to attend a face to face assessment as part of their social security application.  

We believe that advocacy can:
• Provide an enhanced level of support for people during assessment processes.
• Go some way to empowering people in an inherently unequal situation.
• Act as a barrier to inappropriate conduct by assessors.
• Enable a witness to inaccurate recording of findings in such processes.

In our members’ survey, we received correspondence calling for advocacy support to be offered with every claim but with particular promotion to be made among people with mental health problems, people with learning disabilities, people with neurological conditions and older people.  

“Some people will need help to advocate on their behalf.  This should be available to all but there are some groups, including people with MND, who can have difficulty with speech and could benefit from having an advocacy organisation working on their behalf.” Respondent to ALLIANCE survey, September 2016

The ALLIANCE and Scottish Independent Advocacy Alliance (SIAA) were funded by the Scottish Government to deliver a pilot advocacy project in four areas of Scotland (Dundee City, Forth Valley, Glasgow, Midlothian/City of Edinburgh) from May 2015 to October 2016.  The project was specifically tailored to support people with mental health problems, neurological conditions and learning disabilities and over 900 people used the project.  

Key tasks carried out by advocates in assessments centred on:
Prompting clients at varying degrees of frequency.
Providing reassurance, verbally, non verbally or by their presence.
Calming clients down including prior to assessments and when there were delays.
On one occasion challenging assessors, on another challenging the behaviour and decisions of assessment centre staff. 

Many clients are clear that they would not have gone to the face to face assessment, or not have completed the face to face assessment, without the support of an advocate. The presence of an advocate provides reassurance to clients and builds their confidence.  The feeling of having someone on their side is central to this. Preparation work with clients can have a key role in promoting client confidence. The assessment is still a stressful experience for many, despite the presence of an advocate, and communicating at assessments is still a challenging experience.

During the project, significantly greater numbers of people who received advocacy support had successful claims than the national average, with the largest impacts seen on understanding of the process, ability to communicate and preparation.  There were also significant impacts on clients’ confidence about communicating. 

• Previous negative experience of face to face assessments and tribunals is a major trigger for stress and clients worry about their ability to communicate at face to face assessments, and their ability to cope emotionally.
• The process of the face to face assessment is stressful for many clients from start to finish.
• Stress can be triggered by the nature of the situation itself, or the personal and intrusive nature of questioning. This stress can be physically manifested and physical discomfort is often experienced within assessments as a result of their length and the venue in which they are held.
• Most clients were broadly positive about the attitude of the assessor towards them, though a minority expressed a degree of cynicism.  Positive views centred on assessors being responsive to their needs, listening to them, being sympathetic and aware when they were finding the experience tough, and displaying an understanding of their condition.  Some mixed experiences were reported, with some clients highlighting assessors being disorganised.

During its consideration of the delivery of social security in Scotland, the Scottish Parliament’s Welfare Reform Committee concluded that “ultimately we would like to see a system where the need for advocacy and support disappears for the vast majority of claimants.”  Our evaluation of the Welfare Advocacy Support Projecthighlighted that preparation work done in advance of the assessment has proved critical in enabling people to communicate effectively at the assessment.  It also showed that the presence of an advocate in an assessment provides reassurance and builds claimants’ confidence in their ability to communicate, and ensures that they do not forget to raise key issues, whilst also having a positive influence on the approach of the assessor.  Significantly, many clients have indicated that without the support of an advocate, they would not have completed the process.  
In our view, no matter how well designed any new system, how easy to follow, and how sympathetically any face to face elements are delivered, this type of advocacy support will be critical in ensuring that the system is responsive to the needs of disabled people and people who live with long term conditions.

What next steps would you recommend that would help the Scottish Government better understand the likely impact of the transfer of the devolved benefits on independent advocacy services?

As identified in relation to advice and information, there is also likely to be increased demand for independent advocacy support as new benefits are introduced and existing entitlements altered.  Managing capacity is increasingly a challenge that has faced independent advocacy organisations across Scotland, and many organisations are already operating at capacity. The advocates involved in the Welfare Advocacy Support Project (one advocate in each of the four areas) experienced a significant increase in demand leading to a backlog of cases.

The Scottish Government should undertake further discussion with independent advocacy organisations, facilitated by the Scottish Independent Advocacy Alliance, to understand and act upon the impact of the creation of a new social security agency in Scotland.  

15. Complaints, reviews and appeals

How can we ensure that our values underpin the appeals process for a Scottish Social Security agency?

Our members have overwhelming expressed the view that any new complaints, review or appeals processes developed must be infused with an innate understanding of people, their dignity, human rights and a level of compassion which is not currently experienced.  This includes:

• Understanding that the nature of fluctuating conditions mean that face to face assessments may not be wholly reliable and review should be central to this.
• An understanding of how difficult life can be for people with long term conditions and disabled people applying for social security benefits – and therefore not taking decisions which will impact upon finances lightly.
• Benefits should remain until an appeals process is complement and judgement made.  Sanctions should not be used.  
• A set timescale for review and consideration of appeals/complaints.  

We remain concerned that the Mandatory Reconsideration process is a mechanism for discouraging appeals, with success rates proving low, and the introduction of more delay into the system. In some cases claimants are “stuck” at the MR stage over a course of months.  As a result, appeals remain formal and off-putting.  We believe that mandatory consideration should be abolished and replaced with a system akin to the Housing Benefit appeal process, whereby an appeal is submitted directly to the decision maker for reconsideration, and then if they decide not to appeal passed to the Courts and Tribunal Service.

Recent Department for Work and Pensions figures suggest that £0.8bn (0.5%) of total benefit expenditure is overpaid due to official error and £1.4bn (0.9%) is overpaid due to claimant error.  Some respondents to our survey felt that more should be done to encourage a “no blame” culture within a Scottish social security agency which ensures that staff recognise inadvertent errors in the system at as early a stage as possible, rather than cover them up.  Addressing these issues, and making significant savings as a result, should be a priority in any new system.

The Scottish Public Service Ombudsman’s Statement of Complaints Handling Principles outlines an effective complaints handling procedure.

17. Managing over-payments and debt
Could the existing arrangements for recovering social security overpayments
be improved in the new Scottish social security system?

Yes No
If yes, please explain your answer

The likelihood of overpayments occurring is increased by lengthy and complex award letter and notifications.  Many people involved in the Welfare Support Advocacy Project found the information contained in decision letters from the DWP was not easily understood and advocates often needed to explain what the letter meant and the thinking behind it, as well as clarifying basic practical matters such as the period that will elapse before they are called for reassessment
Where an overpayment has occurred, discretion should be applied to make sure that it is appropriate to recover the overpayment (considering the rate of recovery is appropriate and matches the person’s circumstances).  Failure to appropriately consider the impact of these implications can result in people needing support from other parts of the statutory system (health and social care), the third sector and food banks.  Before recovery begins, the social security agency should make sure people have been signposted to local, accessible advice and advocacy.

18. Fraud

Should the existing Scottish Government approach to fraud be adopted for use in our social security system? 

Yes No 

If no, what else should be used instead?

The ALLIANCE and our members have long been concerned that the misrepresentation of fraud in the benefit system has an impact on public perception of the value of social security to the people they support.  A Trades Union Congress study found that support for benefit cuts was often based on a misconception regarding the level of fraud in the system and that fraudulent behaviour was overestimated.  On average Scottish respondents thought that 20% of the welfare budget is claimed fraudulently, while the UK Government’s own figure is 0.7%.  The new social security system must portray a realistic and positive picture of the importance of social security to lives of people who receive them and the level of independence they can foster among some of the most vulnerable people in our society.

Therefore, clear, accessible information about conditions of entitlement and on-going duties should be outlined in any claimants’ charter.  It is imperative that this information is co-produced by people who use the system so that it can be clearly understood and developed in a way that responds to their needs.  However, tackling fraud in the social security system should not be prioritised at the expense of ensuring the social security system is accessible, open and treats claimants with dignity and respect.

20. Uprating

What are your views on the best way to ensure that devolved benefits keep
pace with the cost of living?

The ALLIANCE believes that newly devolved benefits should be uprated in line with the Retail Price Index (the inflationary measure with constitutes the most accurate measure of the real cost of living).  

Figures extrapolated from a Parliamentary Answer by Steve Webb MP, Minister for Pensions on 28 June 2010, suggest that as a result of the UK Government’s 2010 decision to link benefits to the Consumer Price Index rather than the Retail Price Index has led to:

• People in receipt of Disability Living Allowance or Attendance Allowance being £184.60 worse off in the financial year 2015-2016 
• People in receipt of Carers Allowance being £135.20 worse off in the financial year 2015-2016 
• People in receipt of Employment Support Allowance being £132.60 worse off in the financial year 2015-2016 
• People in receipt of Industrial Injuries Disablement Benefit will being £361.40 worse off in the financial year 2015-2016
• People in receipt of Job Seekers Allowance being £132.60 worse off in the financial year 2015-2016
• People in receipt of the basic component of Bereavement Benefit being £332.80 worse off in the financial year 2015-2016

This has had a cumulative impact for the significant number of people who receive more than one of these benefits.

Ensuring the use of the Retail Price Index, would be an important means to ensure that low income households do not continue to fall behind the rest of society.

For More Information

Contact: 

Andrew Strong, Assistant Director (Policy and Communications)

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