A great deal of criticism is levelled at Atos and a good proportion of it is actually misplaced. How many times have you seen from any level within DWP the faintest hint of criticism? To the contrary, Chris Grayling has written personally to all Atos HCPs thanking them for their efforts. It is perfectly clear that Atos is doing exactly what DWP wants it to do in precisely the way it has asked them to do it.
· All of the Atos processes in and around the WCA have been signed off if not designed by DWP.
· All of the content of the WCA has been designed and approved by DWP.
· All of the progressive tightening and/or removal of descriptors has emanated from DWP.
· All of the manuals and handbooks used within Atos and DWP have been designed and signed off by DWP.
· All of the trickery contained within an assessment (the invisible wheelchair for example) is there at the behest of DWP.
· It is DWP that misrepresents the evidence-base it claims supports may of it decisions, by portraying what is at best consultation as if it were whole-hearted support.
· It is DWP that selectively chooses the organisations with whom it “consults”.
· All of the changes to the appeals process to make it harder are being orchestrated by DWP.
So answering the question “What improvements should Atos make?” is not as straightforward as it seems.
One area is undoubtedly to do with the rigour with which individual HCPs perform WCAs, but be careful what you wish for. The fact that Atos HCPs often do not follow the procedures in their WCA handbook at least provides good grounds for appeal, but conversely if they did, this opportunity would disappear. This would then leave just the content of the WCA (its real fitness for purpose) as a generalised basis for appeal, which is a far more subjective and therefore difficult issue to address and prove one way or the other.
Another might be to ramp up the qualifications needed to perform a WCA, but there is a deeper underlying issue that determines current Government thinking.
Occupational Health is not, as some would have us believe, a radically new branch of medicine that (ironically) does not need a wealth of medical knowledge to understand. It is in fact based on well established principles viewed from a slightly different perspective, with slightly different priorities.
The DWP theory is that as OH has only limited medical/clinical content, it does not require in depth medical training and ultimately can be distilled down into an evidence-base that can be reliably interpreted by an administrator with no medical training whatsoever. Any similar suggestion within the NHS itself would be ridiculed – rather like my GP’s receptionist having power of veto over his recommendations.
DWP cannot however answer how on this basis, it can accurately assess factors that cannot be observed fully within a WCA, notably task repeatability over a sustained period and MOST importantly CONDITION VARIABILITY – was the day of the WCAQ a good day or bad day? The only person who can make such an assessment is someone who fully understands the diagnosis, the treatments that have been performed, surgical remedies and the statistical range of potential outcomes, medication, side effects et., etc., etc., not to mention the complexities of mental illness - with all due respect, this needs more than a midwife or physiotherapist and a DWP administrator.
In addition, Derby University has accredited the Atos Disability Assessment training programme, so Atos can therefore claim some legitimacy for what it is doing and even how it is doing it. Professor Harrington as far as I am concerned is only addressing symptoms not causes and is supporting the wrong model. It is the politicians (Tory now, Labour previously) that are driving through these ill thought through injustices, nobody else.