The Professional Standards Authority (PSA) agreed in January to look at concerns about the way regulators deal with complaints about nurses, physiotherapists and paramedics who carry out personal independence payment (PIP) assessments for the outsourcing giants Capita and Atos.
It agreed to act after being contacted last year by disabled activist Mark Lucas, who has twice appealed successfully against the results of what he believes were dishonest PIP assessments.
Hundreds of disabled people have come forward over the last 18 months to tell Disability News Service (DNS) how assessors working for Atos and Capita wrote dishonest PIP assessment reports on behalf of the Department for Work and Pensions.
Many also raised concerns about the apparent refusal of the Health and Care Professions Council (HCPC) and the Nursing and Midwifery Council (NMC) to take their complaints about these assessments seriously.
Only this week, Lucas received an email from HCPC, explaining that it would not take any further action over his complaint about an occupational therapist who had assessed him for PIP.
He believes the assessor deliberately downplayed the seriousness and frequency of his seizures, but HCPC told him it did not believe this had happened and even if it had, “it would be considered a minor error, which would not be capable of amounting to an allegation of impaired fitness to practice”.
Lucas has twice been found ineligible for PIP following assessments, but on both occasions was later awarded eligibility for the PIP standard daily living rate after appealing to a tribunal.
Frustrated at HCPC’s failure to take another complaint about a PIP assessor seriously, he contacted PSA – which reviews the work of the regulators of health and care professionals – last year.
PSA incorporated Lucas’s concerns into its annual review of HCPC, which found this month that the regulator was meeting only four of the 10 required standards for the way it deals with complaints against healthcare professionals, including those who carry out PIP assessments.
Last year, before Lucas contacted the regulator, PSA had reviewed 100 complaints made to HCPC, including a small number relating to PIP assessments.
David Martin, PSA’s concerns and appointments officer, said the 2017-18 review “concluded that there were issues of concern about the HCPC’s process across all of its activity”, in relation to fitness to practise.
These concerns include the way it deals with the initial stages of the fitness to practise process, and how it determines if there is a “case to answer” against a health and care professional.
Among PSA’s concerns are that HCPC makes it too difficult for complaints about a healthcare professional to be accepted into the fitness to practise process, while other cases are closed at the initial stage instead of being referred to an investigating committee panel.
Martin said HCPC had confirmed that PIP assessment work “should be considered in the same way as any other professional activity of its registrants” and that its procedures “require it to fully consider the concerns it receives about PIP assessors”.
He said: “The HCPC was clear that it considers registrants, acting as PIP assessors, are exercising their professional judgement.
“It therefore considers that allegations of misconduct or lack of competence when carrying out PIP assessments could constitute a fitness to practise concern to be investigated in accordance with its usual process.”
He said HCPC was now “undertaking an action plan” to address the concerns PSA has raised about its fitness to practise processes, and that PSA would probably review further HCPC cases in detail over the next couple of years.
A similar annual review by PSA of NMC is due to be published later this year.
An HCPC spokesman said: “The PSA audited a sample of 100 of our cases as part of their review of our yearly performance review in 2016-17.
“While a small number of these cases related to PIP, the audit was not specifically looking at HCPC’s handling of PIP cases.
“HCPC registrants who are employed in assessor roles are recruited because of their skills and experience as registered health professionals. Therefore, their work and conduct needs to comply with our standards.
“If in the course of conducting a PIP assessment a concern is raised regarding a registrant’s fitness to practise, ie lack of competence or misconduct, then this will be investigated following the same robust and thorough processes and applying the same tests as concerns raised in relation to any other area of a registrant’s practice.
“We have also provided input into the PSA’s review into how regulators approach fitness to practise concerns in relation to PIP assessments and have confirmed our view that the PIP assessment process requires the registrant to employ their professional competencies.
“This year we continued to meet the majority of the PSA’s Standards for Good Regulation.
“Although we did not meet all the standards relating to fitness to practise, the PSA has acknowledged our on-going work to improve our performance in this area and stated that we have made ‘significant progress during this review period’.
“We continue our programme of improvement work to address the issues that were previously identified.”
But Lucas was heavily critical of PSA’s efforts to address his concerns.
He said PSA was “a joke” and a “toothless quango”.
He said: “I am not happy with the way PSA have treated me and it is behaviour that I have been subjected to on many occasions over the last few years.”
Lucas said that complaints processes are “designed to abuse” disabled people because they first “promise the earth”, then “forget” the complaint, and finally “communicate the result from the complaint in a letter with preapproved techniques of neutralisation and consolatory phrases like ‘we realise you will be disappointed’”.
He said: “This experience of the last few years has given me anxiety over making complaints.
“I have spent much time and written many letters, but it is all for nothing because organisations like the PSA are just for show.”
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