Medical Services for the DWP

Transcript Medical Services for the DWP

Medical Services for the DWP

National Customer Representative Group Forum

Gary Freeman

New Court, 5 th June 2008

Atos Healthcare™ is a trading name of Atos Origin IT Services UK Limited. Atos Healthcare™ – a trademark of the Atos Origin Group.

Introductions

» Gary Freeman General Manager (DWP Contract), Atos Healthcare » Dr Angela Graham Assistant Medical Director, Atos Healthcare » Brian Pepper Customer Relations Manager, Atos Healthcare » Dr Moira Henderson DWP Principal Medical Advisor 2 National Customer Representative Group Forum – 5 th June 2008

Today’s Topics

» Roles and Responsibilities (Government / The DWP / Atos Healthcare) » Atos Healthcare Specifics • Typical “Customer Journey” • Examination Centres • Healthcare Professionals • Medical Quality

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Integrated Quality Audit System

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Rework • Customer Satisfaction Surveys • Complaints Handling • Metrics and Targets • Preparing for ESA 3 National Customer Representative Group Forum – 5 th June 2008

Roles & Responsibilities

The Government

» Legislation » Regulations

The DWP

» Developing/maintaining Medical Protocols (with Atos Healthcare) » Setting Metrics & Targets • • • Customer Experience Quality of Reports Efficiency of Service » Monitoring outcomes against target » Making Benefits Decisions

Atos Healthcare

» Developing/maintaining Medical Protocols (with the DWP) » Developing/using IT systems to help ensure that the Medical Protocols are deployed consistently » Undertaking initial assessment of claims » Collecting Further Medical Evidence (e.g. from GPs, CPNs, etc) as required » Scheduling face-to-face examinations » Undertaking face-to-face examinations » Providing the DWP with advice » Providing the DWP with assessments 4 National Customer Representative Group Forum – 5 th June 2008

Customer Journey – for Majority of Customers

Send Out ESA50 Complete ESA50 and return within 14 days Schedule Appointment Receive Confirmation Letter (AL1) Undertake Assessment (LCW & WFHRA) Complete Exam report online Receive Customer Satisfaction Questionnaire

Customer Atos Admin Atos VCC Atos HCP DM or PA  

ESA50

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ESA85

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WFHRA

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WFHRA

Medical Examination Centres (MECs) and Medical Services Centres (MSCs)

» >140 MECs throughout Great Britain » The smallest: • have a single examination room, • are only open when there is sufficient demand (e.g. one morning/month ) » The largest: • have >20 examination rooms, • are open 5 days/week – and sometimes at weekends » Domiciliary Visits: • for those it might be unreasonable to call into a MEC (e.g. long travel times) » Each MEC is associated with a regional MSC » Staff in an MSC working closely with DWP colleagues in the associated Government Office Region (GOR) 6 National Customer Representative Group Forum – 5 th June 2008

Our Health Care Professionals (HCPs)

7 » Most IB and ESA assessments may be undertaken by either a doctor or a nurse » They use an IT support system (LiMA) • to help ensure consistent quality based on evidence-based medical protocols • to ensure that reports are legible • to make the reports quickly available to the DWP » Doctors: • must be registered with the General Medical Council (GMC) • must have 3 years broad-based clinical post-registration experience • must achieve approval (post training) from the CMA in the appropriate benefit » Nurses: • must be registered with the Nursing and Midwifery Council (NMC) • must have 3 years broad-based clinical post-registration experience • must achieve approval (post training) from the CMA in the appropriate benefit National Customer Representative Group Forum – 5 th June 2008

Our Training of HCPs

» Generic Training • Principles of Disability Analysis • Professional Standards (including manner & behaviour) • Multi-cultural Awareness » Scrutiny Training • Provision of advice to the Decision Maker when appropriate on the basis of available documentation within a claimant’s file • Theory and casework exercises, followed by supported individual casework » Training to undertake Benefit-Specific Assessments • Learning Path approach for IB, DLA/AA, IIDB, SPVA assessments.

• Modular training with competency testing at each stage • Includes a focus on Communication Skills • Approval Process 8 National Customer Representative Group Forum – 5 th June 2008

Integrated Quality Audit System (IQAS) – 1

» Audit is undertaken by experienced approved HCPs with specialist training. » Annual external validation of each auditor’s appointment » Reports are identified as satisfactory/unsatisfactory • Unsatisfactory reports are amended before they are returned to the DWP • In most instances amendment undertaken by the original author • A small number of cases will require further assessments » 18,363 Random audits undertaken in the past 12 months • Target is to achieve 95% satisfactory reports • In the past 12 months achievement has been 97.8% » In total 50,972 audits undertaken in the past 12 months • This means that 2.55% of all referrals were subject to audit 9 National Customer Representative Group Forum – 5 th June 2008

Integrated Quality Audit System (IQAS) – 2

» Approval Audit • As part of the approval process 100% of cases are audited following training until competence is assured » Random Audit • A proportion of cases selected at random for audit » Targeted Audit • Where a potential quality issue has been identified, audit is undertaken to clarify the issue and to ensure that feedback / training results in resolution » Rolling Audit • Undertaken where a HCP has not been audited in the past 5 months 10 National Customer Representative Group Forum – 5 th June 2008

Rework

» Continuous monitoring of individual rework levels • Simple “slip of the pen” errors are amended by an approved employed HCP • Most amendments / clarifications are made by the original author » Rework • Target is to receive <1% • In the past 12 months rework has been 0.17% 11 National Customer Representative Group Forum – 5 th June 2008

Customer Satisfaction Surveys

» Over 2,000 questionnaires are sent out every month by an independent 3 rd party market research company » Areas covered include: • Appointment arrangements • Receptionist • Practitioner interaction • Handling queries • MEC facilities » From the response a “Customer Satisfaction” rating is determined • Target is to achieve 90% overall customers satisfaction – derived from key questions relating to each area • Actual overall average during past 12 months has been 92% – with practitioner ratings consistently higher » The CRT analyses responses and identifies improvement opportunities 12 National Customer Representative Group Forum – 5 th June 2008

Complaint Handling

» Complaints are received by Customer Relations Team (CRT) » The CRT manages each complaint until its resolution » On average: • 230 complaint letters are received each month • This means 1 in 236 exams results in a complaint (i.e. 0.4%) » Each complaint is assigned to issue codes relating to • Practitioner approach / content / waiting times / administrative etc » The investigation will result in one of four outcomes: • No action (i.e. unfounded) • Proactive Feedback (i.e. unproven) • Remedial (i.e. specific activity) • Formal (i.e. disciplinary) 13 National Customer Representative Group Forum – 5 th June 2008

Metrics and Targets

» Customer Experience • Waiting Times (average < 10 mins) • Customer Sent Home Unseen (average < 1%) • Customer Satisfaction (>90%) • Acknowledging a complaint letter (2 days) • Completing an investigation into a complaint (20 days on average) » Quality • IB PCA examination <5% • IIDB examination <5% • DLA/AA examination <5% • IB PCA scrutiny <5% » Efficiency • Average time from receipt of claim (from DWP) to delivery of report:

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Varies with benefit stream 14 National Customer Representative Group Forum – 5 th June 2008

The following DO NOT have targets

» The time to complete an examination • The key is to follow the Medical Protocol – when it’s done, it’s done • We know the most likely duration and schedule around that » The number of complaints we receive • We are more interested in Complaint Outcomes • Remedial & Formal – action is taken swiftly • Proactive Feedback – we look for trends and act accordingly • No action – no action » The percentage of customers that receive benefits • We are not routinely told of who does or does not receive benefit • Our focus is to provide a professional assessment based upon the Medical Protocols, which in turn are based upon the regulations and legislation 15 National Customer Representative Group Forum – 5 th June 2008

Preparing for ESA

» Developing Medical Protocols for ESA Work Capability Assessment (WCA) » Recruiting of additional practitioners » Training of additional practitioners • The “Gateway into Work” mindset • The LCW • The WFHRA » Training of admin staff • The “Gateway into Work” mindset 16 National Customer Representative Group Forum – 5 th June 2008

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Gary Freeman m 07733 315 048 [email protected]

Atos Healthcare™ is a trading name of Atos Origin IT Services UK Limited. Atos Healthcare™ – a trademark of the Atos Origin Group.

Medical Services for the DWP

Transcript Medical Services for the DWP