Atos will use just 19 doctors to carry out personal independence payment (PIP) medical assessments in most of England and all of Scotland from April next year, according to bid documents lodged in the House of Commons library. The majority of the medical staff will be made up of 933, mostly private sector, physiotherapists who are likely to have very little mental health training. It is believed that Atos will have to assess well over a million claimants –​ some on paper only - for the new benefit, of whom at least a quarter are likely to have mental health conditions or learning difficulties.

Working age disability living allowance claimants will begin being assessed for the replacement benefit PIP from next April, with around half a million claimants expected to lose out under the process. Atos, who won the lion’​s share of the lucrative contracts, will carry out all PIP medicals in London and the South of England and in Scotland and Northern England. Capita won the contract for Wales and Central England.

Atos have already announced that they are contracting with NHS trusts to provide venues for assessments, but what has not been made clear is the huge reliance on the private sector to come up with staff –​ and especially physiotherapists - to carry out the actual assessments. Atos themselves are providing very few staff other than senior managers, auditors and trainers, plus 35 health professionals and 180 administrators.

Figures in the bid documents reveal that Atos will use 433 physiotherapists, 173 nurses, 35 occupational therapists and 9 doctors in London and Southern England. Just 19% of the service will be provided by NHS staff, whilst private sector company Premex will provide 30% and The Injury Care Clinics will provide 15%.

In Scotland and Northern England, Atos plan to use 500 physiotherapists, 200 nurses, 40 occupational therapists and 10 doctors. The NHS will provide 36% of the service.

Atos say that this mix of health professionals was based on a number of considerations, including the “​cost differentials between the types of HPs [health professio​nals]”​ and “​the desire for this work”​ amongst different types of health professionals. There is no mention of how many, if any, of the nurses will be specialist mental health nurses.

Medical assessors, who are only expected to work part-time for Atos as well as continuing with their private or NHS practices, will receive just 7.5 days’​ training. Around 5 days of this will be classroom-based and the rest “​self-directed reading, web-based modules and DVD material which can be accessed by HPs on a flexible basis, both at their place of work and at home.”​.

Training has to cover a very wide range of subjects, including PIP legislation, how to complete the medical report, disability awareness and interview skills. This raises the question of just how much training physiotherapists and nurses will receive in areas such as mental health and learning difficulties.

Atos do concede that physiotherapists may need some additional training:

“​Support’​ training modules will be delivered to some HP groups, as appropriate. For example, physiotherapists will require support in theoretical and practical aspects of mental health assessment . . .”​

But with so many other areas to cover, such training is likely to be very limited.

‘​Mental health champions’​ will be amongst the 35 condition champions employed by Atos throughout the UK to advise staff carrying out medicals, where it is deemed necessary. But many claimants will consider that this is no substitute for employing staff with relevant qualifications to carry out the actual medicals.

Atos are enthusiastic about delivering PIP and claim that “​we will train everyone involved in the delivery of the service to a standard which delights the claimant and meets our commitments.”​

Sadly, Benefits and Work suspects that there will be quite a few rather less than delighted claimants in the years to come.


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