Benefits and Work has obtained documents which show that the DWP failed to take steps to prevent further claimant deaths following a coroner’s warning in January 2014, in spite of agreeing to do so. However, the department flew into a panic 20 months later and tried to mount a cover-up when the coroner’s report was uncovered by a journalist.
Coroner’s warning discovered
In September 2015 campaigning journalist John Pring of the Disability News service revealed that a coroner had issued a prevention of future deaths warning following the death of claimant Michael O’Sullivan. The warning is issued where a coroner believes that more deaths may occur unless action is taken.
Michael O’Sullivan committed suicide in September 2013. He had been suffering from anxiety and depression for a number of years and had previously been in receipt of incapacity benefit. He applied for employment and support allowance (ESA) but was found fit for work and refused benefit.
In the report the coroner stated that:
“I found that the trigger for Mr O ’Sullivan’s suicide was his recent assessment by a DWP doctor as being fit for work .”
The Coroner went on to say that:
“During the course of the inquest , the evidence revealed matters giving rise to concern. In my opinion, there is a risk that future deaths will occur unless action is taken . In the circumstances , it is my statutory duty to report to you [the DWP]. “
The matters of concern which the coroner set out were:.
“The DWP assessing doctor (who saw Mr O ’ Sullivan for a 90 minute consultation) did not take into account the views of any of Mr O’ Sullivan’s treating doctors, saying that the ultimate decision maker would do that.
“However, the ultimate decision maker (who is not, I understand, medically qualified) did not request and so did not see any reports or letters from Mr O’Sullivan’s general practitioner (who had assessed him as being unfit for work), his psychiatrist or his clinical psychologist.”
As a result of that warning the DWP admitted further medical evidence should have been requested in line with their policy and that they would ‘issue a reminder to staff about the guidance related to suicidal ideation that has been described in this report.’
The story received national coverage in newspapers as diverse as the Guardian and the Daily Mail.
However, when Benefits and Work attempted to obtain a copy of the reminder that had been sent out by the DWP, along with details of who it had been sent to and on what date, the DWP mounted a cover-up.
In their initial response the DWP simply directed us to the latest edition of the Work Capability Assessment Handbook issued to health professionals.
When we challenged this, the DWP pretended to misunderstand us and issued the same answer again.
We then took the issue to the Information Commissioner’s Office.
The DWP ignored a deadline for a response to the ICO.
Just as the ICO was about to issue an information notice to the DWP, which legally obliges them to make a response, we received a reply from the DWP which stated:
“Under our records management policy internal memos must be retained for one year and so, due to the passage of time, we do not hold the information requested. However, to be helpful I can confirm that a reminder was sent out on 2 October 2015 which stated the following:
“The current filework guidelines are available in the knowledge library. Current version is 10 and it states: “Where there is evidence of a previous suicide attempt, suicidal ideation or self-harm expressed in the ESA50/ESA50A, the HCP must request FME.”
The 2nd October 2015 was the week after press reports about Michael O’Sullivan appeared.
Benefits and Work pressed for further information and eventually, the DWP provided us with a copy of the memo of 2 October.
They insisted that the names of all the recipients should be removed, but the ICO ruled that one recipient, Angela Graham, was not a junior member of staff and could reasonably expect to be identified.
There is an Angela Graham who was clinical director for the WCA contract for Atos, who Disability News Service reports “claimed that claimants came into assessment centres with knives and “threaten to throw acid in the face of the receptionists”.
“There is no wriggle room here”
The memo, which appears to have been sent out by Maximus who took over the WCA from Atos in March 2015, is reproduced in full below.
It requires an email from every WCA health professional who examines claimants’ files to say they have read and understood it. It goes on to deal specifically with further medical evidence (FME) ‘in those indicating previous or potential self-harming behaviour in their ESA50/50A’:
“We have had two historical cases recently brought to our attention where we have been challenged regarding a decision not to request FME at the filework stage. In both of these cases there has ultimately been a tragic outcome. Whilst the outcome may or may not have occurred in any case, the facts remain, that at filework the practitioner has not followed guidance.
“The current filework guidelines are available in the knowledge library. Current version is 10 and it states
“Where there is evidence of a previous suicide attempt, suicidal ideation or self-harm expressed in the ESA50/ESA50A, the HCP must request FME.
“This is clear and unequivocal and has been in guidance since version 6 dated December 2010. There is no wriggle room here – you must request FME.
“If you follow the guidance then we can defend you should a tragic incident occur. If you do not follow the guidance we cannot.”
Here at Benefits and Work we have not the slightest doubt that no similar, earlier memo was sent out by the DWP as a result of the Michael O’Sullivan inquest. If health professionals had been required to send emails in 2014, there would have been no need for them to do so again.
The reality is much more likely to be that the DWP didn’t bother to take any action following the coroner’s warning, because the death of a claimant is not something that weighs heavily upon them. It was only when the press took up the story 20 months later that the DWP, panicking that they had been caught out, finally sent out a reminder to staff.
Just as the coroner feared, more lives are likely to have been lost as a result.
The question now is, will those responsible be made to pay the price or will there be more cover-ups and more “wriggle room” for the guilty parties?
THE MEMO IN FULL
From: (Withheld: Section 40(2) FOI Act)
Sent: 02 October 2015 13:29
To: (Withheld: Section 40(2) FOI Act) (Atoshealthcare)
Cc: (Withheld: Section 40(2) FOI Act) @maximusuk.co.uk'; (Withheld: Section 40(2) FOI Act) 'Angela Graham'; (Withheld: Section 40(2) FOI Act)
Subject: Filework FME - IMPORTANT
Text below to go out to all filework practitioners immediately please.
As a business we require written confirmation from each practitioner that they have read and understood this. I suggest they each return an email to whoever can coordinate this in your unit. These records must be permanently kept in each unit. This is urgent and certainly by the end of next week we need a return from each CM that all bar the unavailable have confirmed read and understood. You also need to have a robust system in place to catch those who are currently off and any new filework practitioners you train in future.
All Filework Practitioners and those auditing or otherwise managing them MUST READ AND UNDERSTAND THIS.
FME in those indicating previous or potential self harming behaviour in their ESA50/50A.
We have had two historical cases recently brought to our attention where we have been challenged regarding a decision not to request FME at the filework stage. In both of these cases there has ultimately been a tragic outcome. Whilst the outcome may or may not have occurred in any case, the facts remain, that at filework the practitioner has not followed guidance.
The current filework guidelines are available in the knowledge library. Current version is 10 and it states
Where there is evidence of a previous suicide attempt, suicidal ideation or self-harm expressed in he ESA50/ESA50A, the HCP must request FME.
This is clear and unequivocal and has been in guidance since version 6 dated December 2010. There is no wriggle room here – you must request FME.
If you follow the guidance then we can defend you should a tragic incident occur. If you do not follow the guidance we cannot.
I am sure most people’s reaction will be that you all already do this. Unfortunately we have clear evidence where it has not occurred.
(Witheld: Section 40(2) FOI Act) | National Clinical Manager
Centre for Health and Disability Assessments
Cardiff ASC, Block 2, Government Buildings, Gabalfa, Cardiff, CF14 4YJ
MOB: (Witheld: Section 40(2) FOI Act) (Witheld: Section 40(2) FOI Act)