Update Tuesday 30 April: Discussion of the DWP’s confirmation that Atos does not report to the department on the performance of mental function champions

Because this has turned into a long blog which I’ve been updating for several months, I’m going to start this update with a brief background for new readers:

For several months now, I’ve been trying to get the DWP to explain how it quantifies the performance of mental function champions. Mental function champions are the individuals whom Malcolm Harrington suggested that Atos add to the work capability assessment process to “spread best practice amongst Atos healthcare professionals in mental, intellectual and cognitive disabilities.” The role was created as a concession to the many serious concerns that people have raised about the appalling effects of the Employment and Support Allowance work capability assessment on people with mental health illnesses (I wrote a long article about that, the experiences of people I’ve interviewed and attended WCAs with and concerns about WCA descriptors and outcomes here. There’s a good anlysis of concerns around regulations 29 and 35 here). Mental function champions do not advise or support ESA claimants: they provide advice and coaching to Atos healthcare professionals.

Last year, on November 5, Mark Hoban told parliament that “we have introduced a mental health champion in every single assessment centre throughout the country.” Actually, he had not. The DWP told me that 60 of these MFCs were in place and that they largely worked a phone advice line. The DWP didn’t want to go further than that: its officers told me to contact Atos for more on MFCs.

Pinning Atos down on the details has been a struggle, as readers of this blog will know. Since late last year, a group of Newcastle mental health service users and support workers and I had been asking Atos to agree to a meeting up between us and MFCs. There were concerns about the real impact of MFCs on WCAs for people with mental health problems.

Harrington observed in his year three review: “…mental function champions have been introduced at a regional level, rather than in each assessment centre as was originally recommended. Given scarce resources, the review supported this approach… Some representative groups claim that awareness of the champions is low, and that those who are aware of them believe they have little or no impact on the quality of mental function assessments. The review asked Atos to report on the effectiveness of their mental health champions. They said that their healthcare professionals found the champions to be ‘a great resource’ and that they were of ’great use to put any uncertainties into perspective’.”

We wanted to meet with at least one MFC because of the uncertainty about the role and its impact on WCAs for people who must go through them. It’s all very well to claim a champion is a “great resource” and of “great use” but that claim needs to be quantified, especially on a topic as serious as this. Considerable concerns remain about the experiences of people with mental health illnesses as they go through work capability assessments. Transparency around the MFC role is required and that is why we sought a meeting. The meeting went ahead very recently, on the proviso that I did not attend (you can read the story of the attempt to set up that meeting below, on the original blog).

Several things have happened since I first posted this blog. The development I’m updating here is that Hoban and the DWP concede that Atos does not report back to the department on MFC performance. We’ve been trying since February to get details about the measures Atos uses to report MFC performance to the DWP. The North Durham MP Kevan Jones has also been pursuing questions on this topic in parliament as you’ll see below.

The questions I sent to the department early in February 2013 were: “Could you let me know what measures there are for reporting MFC performance to the DWP and if there are such reports, where they are kept – ie, does Atos report to the DWP on topics like the number of calls MFCs take, the topics they cover, satisfaction rates from HCPs for the service, etc?” The DWP finally came back today and said that “Atos don’t report back to the DWP on things like that” and recommended that I ask Atos for its reporting procedures. There are alarm bells going off all over here. How can the department monitor the impact of MFCs on the work capability assessment if it does not formally monitor the role?

Kevan Jones has been trying to find out more via the parliamentary route and getting nothing helpful from Hoban:

25 March 2013:

Kevan Jones (North Durham, Labour) Hansard source (Citation: HC Deb, 25 March 2013, c991W)

“To ask the Secretary of State for Work and Pensions to whom Mental Function Champions (a) report and (b) are accountable; and how such a reporting process is documented.”

Mark Hoban (Fareham, Conservative)

“Mental Function Champions report to their line managers within Atos Healthcare. There is an annual appraisal process for all health care professionals.”

And then most recently: 10 Apr 2013

Mr Kevan Jones: To ask the Secretary of State for Work and Pensions (1) what performance measures are in place to evaluate the effectiveness of Mental Function Champions on workplace capability assessments;  (2) what data his Department collects, maintains and holds on the performance of Mental Function Champions.

Mr Hoban: “There are no formal performance measures around the role of the mental function champion and no separate data is held on the specific performance of mental function champions but routine monitoring of the quality of assessments and customer satisfaction takes place as part of the contractual arrangements between DWP and Atos Healthcare. In addition, Professor Harrington’s second review noted that the mental function champion role is being well-utilised and that health care professionals have welcomed the advice and support.”

He doesn’t measure the performance or impact of this role? How does he know what real impact it has had on an assessment process that has been so problematic for people with mental health problems? More importantly – how do we?

More soon.
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This is an update for Sunday April 28The meeting went ahead. More on this soon. Neither Atos nor the DWP have been able to produce reporting information, KPIs, or monitoring information for us on the MFC role, despite repeated requests.

Update Sunday March 24 There has been movement of a kind on this, with a meeting of one hour set up. More on that and other developments soon.

Update Thursday 14 February 2013: Atos has been in contact and discussions are underway to set up a meeting. Interesting. They reckon they sent an email to a generic email address of one group on the list and made a phone call a week or so ago – a fairly half-hearted attempt to set up a meeting if you ask me, but at least we’re underway. Ish. I want to know what this role really does, or doesn’t, do for people with mental health problems who must go through WCAs. I’ve seen plenty of examples of the problems WCAs cause people and more needs to be known about this MFC role – the role that was created to, purportedly, improve WCAs for people with mental health problems. More soon.

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Original blog:

For several months now, as readers of this site will know, a group of Newcastle mental health service users and support workers and I have been asking Atos to agree to set a meeting up between us and Atos’ work capability assessment mental function champions. (Mental function champions do not advise or support claimants: they provide advice and coaching to Atos healthcare professionals).

I’m posting this article to let you know that despite repeated assurances from Atos that our meeting will be organised, it hasn’t been. Atos keeps saying it’ll set a meeting up for us, but never does. We call Atos and we email Atos and they say they’ll get right onto it. They don’t. So we call Atos and email Atos and they say they’ll get right onto it. They don’t. So, we got in contact with Atos again about a fortnight ago and were assured that a call would be made and a meeting would be set up. Nothing’s happened. It has occured to us that Atos doesn’t want us to meet with mental function champions. Or something. We’re sure that they’re there, etc. We just want to see them and find out more about the “role.”

Mental function champions are the individuals Malcolm Harrington suggested that Atos added to the work capability assessment process to “spread best practice amongst Atos healthcare professionals in mental, intellectual and cognitive disabilities,” whatever that means. Last year, the DWP told me that 60 of these MFCs were in place (I suppose we take that as written for now) and that they largely worked a phone advice line. Mark Hoban went somewhere else with it, into territory that may best be described as make-believe: on November 5, he told parliament that “we have introduced a mental health champion in every single assessment centre throughout the country.” The DWP rowed back on that and admitted that there wasn’t a mental function champion in every single assessment centre in the country. There were/are 60, apparently, and they’re mostly on the phone. The DWP didn’t much want to talk about that: its officers told me to contact Atos for more on MFCs. And as I say – pinning Atos down on the details has been a struggle.

In his first-year review of work capability assessments, Harrington observed that concerns had been raised about Atos assessors’ knowledge and understanding of mental health conditions. “The short training course in mental health that Atos assessors receive is proving nowhere near adequate to allow them to accurately assess applicants,” MIND said in the review.

I’d take it a good few steps further than that. Complaints and concerns about the appalling effects of WCAs on people with mental health problems are, as I’ve written before, widespread and well-documented: work capability assessments and descriptors for disability benefits place too much emphasis on basic physical readiness for work, do not account for the fluctuating nature of some mental health illnesses and assume that everyone is always in a position to offer a detailed picture of their circumstances. Once found fit for work, people’s benefits are cut, they must appeal or apply for jobseekers’ allowance, they can fall behind on their rent and bills and their mental health really begins to deteriorate, as this doctor will tell you. I have witnessed some of this myself, having attended work capability assessments with people who have mental health problems and followed them as they have gone through the stressful appeals process. Stephen, a 54-year-old man with schizophrenia who was one of those people, got a zero-points score in his initial WCA assessment, but was placed in the ESA support group on appeal – a monumental turnaround by the DWP that made everyone involved wonder at the criteria. Claimants with mental health problems have sought recourse in court: last month, the courts heard a case which, if won, will put the onus on the DWP to make sure medical evidence from practitioners is sourced from the start of the ESA application process for people who have mental health problems.

Those issues being very much the case, it is understandable that people with mental health problems and their supporters want to know how the MFC role works. Meeting with champions and asking them about their daily role seemed as good an approach to this as any. It certainly seemed a better approach than asking Atos directly, given the thin results that has yielded.

I asked Atos to explain exactly who MFCs are and the skills they bring to WCAs. Atos’ response was short on specifics: the company had, apparently, “invited leading external experts in mental health to help shape the role for the mental function champions,” and the champions “work alongside our healthcare professionals, supporting them in a range of different ways.” The word “alongside” could be considered a stretch – as we’ve seen, the DWP said that MFCs advise Atos HCPs down a phone (“telephone-based support” Atos calls it). Details of the “different ways” support was provided were not forthcoming in the response I received. I received this instead: “Our mental function champions are selected for the role because they have considerable expertise within the mental function field. They may already have higher training or a higher qualification in the field of psychiatry or have experience working in Mental Health, Learning Disability or Cognitive Impairment.” Presumably, the word “may” there means that some may not. There’s an awful lot of Maybe going on here.

Anyway. People want to meet with MFCs because they want to know more about the “role” and see it in action. It’s important. It’s very important. The MFC role is, it could be said, to be the main means by which concerns about WCAs and mental health problems have been “addressed” (ahem) to date. So – people need specifics. They need to know how, on a day-to-day basis, the role “spreads best practice” so that it improves WCAs for people going through them – assuming that is what is does. As I’ve observed – the jury’s out on that one. Things are too difficult for people going through WCAs for this topic to be left at a few press statements from Atos. I know we’re not the only people who are interested, too. I’m also pretty sure that Atos doesn’t want us to be.