Half of disability assessment bodies will be from the NHS

BMJ 2013; 346 doi: (Published 19 February 2013) Cite this as: BMJ 2013;346:f1143
  1. Adrian O’Dowd
  1. 1London

Half of the 14 partner bodies that have been subcontracted to carry out new disability assessment work led by a private company are NHS organisations.

Atos Healthcare, the company which the government contracted to do assessments for a new disability benefit, published a list this week of the 14 “supply chain partners” that it has made agreements with to do most of the frontline work.

Observers, however, are puzzled as to why public sector providers have gone through a private sector intermediary to do work for the public sector.

Last year, the Department for Work and Pensions awarded a five year contract to Atos, worth £400m (€464m; $620m), to deliver assessments for a new disability benefit called a personal independence payment (PIP), which will replace the existing disability living allowance.

The government says the current allowance is out of date and that 71% of claimants get the benefit for life without systematic checks to see if they still need it.

Atos said that from April it would begin working with local NHS services and health professionals to deliver these assessments in England and Scotland.

Face to face interviews for the assessments have to be carried out by registered practitioners such as nurses, physiotherapists, or occupational therapists. It is believed that most of existing claimants will not be reassessed until after 2015.

As well as private firms and charities, the list of partner bodies includes:

  • Bedford Hospital NHS Trust

  • Croydon Health Services NHS Trust

  • King’s College Hospital NHS Foundation Trust

  • Lancashire Care NHS Foundation Trust

  • Pennine Acute Hospitals NHS Trust

  • University College London Hospitals NHS Foundation Trust

  • York Teaching Hospital NHS Foundation Trust.

Nick Barry, general manager of the contract for the personal independence payment, for Atos said: “This is a new approach to delivering health and disability assessments working with local NHS services to help ensure a quality service is delivered in a way that best meets local needs.

“This means that the face to face consultations will be undertaken by organisations with experienced staff who are used to dealing with people with disabling conditions, differing needs and challenges.”

Tony Wilson, policy director for the think tank the Centre for Economic and Social Inclusion, welcomed the involvement of NHS organisations, but said he was puzzled as to why the work had been contracted out in the first place.

“These organisations are certainly experienced in the reassessment of people on incapacity benefits,” he told the BMJ. “They also have the necessary medical and social understanding of the barriers that disabled people face.

“But it does rather beg the question of why the public sector needs to contract to an intermediary who then subcontracts back to what would seem to be the pretty obvious public sector capability to deliver this.”

It was unclear, he added, why NHS bodies had not bid for the contracts themselves directly.

A spokesman for the Department for Work and Pensions said: “It was open to NHS organisations to bid for a place on the Health and Disability Assessment framework but none did so.

“We believe that it is right for Atos to partner with the NHS to offer PIP claimants familiar surroundings and experienced health professionals.”

Atos and the Department for Work and Pensions were criticised last week in a report1 from the Public Accounts Committee for their handling of work capability assessments for the government’s employment and support allowance, saying too many decisions had been wrong, causing hardship to claimants.


Cite this as: BMJ 2013;346:f1143


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