Attributes for assessments in DLA/AA

120 Pages·2012·0.48 MB·English

by  Nick Bhogal

M S
EDICAL ERVICES

PROVIDEDONBEHALFOFTHEDEPARTMENTFORWORKANDPENSIONS

Training and Development Unit

Guidance for Health Care
Professionals undertaking Disability
Living Allowance / Attendance
Allowance Assessments

Handbook
MED/S2/HCPDLAAAASHB~0010

Version: 11 Final

11th January 2012

Medical Services

Foreword

This guidance has been produced as part of the training programme for Health Care
Professionals seeking approval by the Department for Work and Pensions Chief Medical
Adviser to carry out assessments in Disability Living Allowance and Attendance Allowance.
All Health Care Professionals undertaking medical assessments must be registered medical
or nursing practitioners who in addition, have undergone training in disability assessment
medicine and specific training in Disability Living Allowance and Attendance Allowance. The
training includes theory training in a classroom setting, supervised practical training, and a
demonstration of understanding as assessed by quality audit.
This guidance must be read with the understanding that, as experienced medical or nursing
practitioners, the Health Care Professionals will have detailed knowledge of the principles
and practice of relevant diagnostic techniques and therefore such information is not
contained in this guidance.
In addition, the guidance is not a stand-alone document, and forms only a part of the training
and written documentation that a Health Care Professional receives. As disability
assessment is a practical occupation, much of the guidance also involves verbal information
and coaching.
Thus, although the guidance may be of interest to non-medical readers, it must be
remembered that some of the information may not be readily understood without background
medical knowledge and an awareness of the other training given to Health Care
Professionals.

Office of the Chief Medical Adviser
January 2012

Guidance for HCPs who undertake DLA/AA Assessments 11 Final
MED-S2/HCPDLAAAASHB~0010 Page 2

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Document control
Superseded documents
Guidance for Examining Health Care Professionals v8
Version history
Version Date Comments
11b draft 8th December 2011 Comments from HWWD incorporated
11a draft 1st November 2011 Updated at schedule 28 review by Medical Training &
Development
10 Final 25 October 2010 Signed off by CMMS
Changes since last version
References to Incapacity Benefit (IB/PCA) removed
Examination replaced by assessment
Term ‘Examining HCP’ removed
References to LiMA included
UTS 33/2010 included (Retention of notes containing claimant details)
UTS 29/2011 included (Harmful Information)
References to CFS changed to CFS / ME
Section 13.2 Audio and visual recording of assessments updated

Outstanding issues and omissions

Issue control
Author: Medical Training & Development
Owner and approver: The Medical Director
Signature: Date:
Distribution:
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Contents
Section Page
1. Abbreviations 9
2. About this Guide 10
3. The Department for Work and Pensions (DWP) 11
3.1 Introduction 11
3.2 Structure of the DWP 11
4. Atos Healthcare 13
4.1 Introduction 13
4.2 Role of Atos Healthcare 13
4.3 Conditions of work 13
4.4 Professional Standards 14
5. The role of the Health Care Professional 15
5.1 Introduction 15
5.2 Training and approval 15
5.3 Ongoing training 16
5.4 Auditing of Reports 17
6. Main Features of Disability Living Allowance & Attendance
Allowance 18
6.1 Disability Living Allowance (DLA) 18
6.2 Attendance Allowance (AA) 18
6.3 Decision-making 18
6.4 Self reporting 19
6.5 Disability criteria 19
6.6 Personal care 20
6.7 Three rates of the care component 20
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6.8 Mobility problems 20
6.9 Attendance Allowance 22
6.10 Qualifying periods 23
6.11 Terminal illness cases 23
6.12 Children under the age of 16 23
7. Factors considered by the Decision Maker - care 24
7.1 Severe disability 24
7.2 Attention 24
7.3 Supervision/watching over 25
7.4 The main meal test 25
7.5 Are the needs reasonable? 26
7.6 Age 26
7.7 Aids to help the disabled 27
7.8 Day or night supervision/attention 27
7.9 Children 27
7.10 Variable needs 27
8. Factors considered by the Decision Maker - mobility 28
8.1 Unable or virtually unable to walk 28
8.2 Exertion 28
8.3 Amputations 29
8.4 Walking aids 29
8.5 Deafness and blindness 29
8.6 Severe mental impairment 30
8.7 Guidance and supervision 30
8.8 Intermittent problems 31
8.9 Children 31
8.10 Benefits of getting out and about 31
9. Equal Opportunities and Other Legislation 32
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9.1 Equal Opportunities Policy 32
9.2 The Rehabilitation of Offenders Act 1974 32
9.3 The Equality Act 2010 33
10. Administrative guidance for the HCP 36
10.1 Making appointments for domiciliary visits 36
10.2 Telephone contact with claimants 37
10.3 Identification of the claimant at the assessment 38
10.4 Special need requirement 39
10.5 HCP reports completed by a third party 40
10.6 Abortive visits (no report provided) 41
10.7 Non aborted visit (report incomplete) 43
10.8 The claimant refuses you entry 43
10.9 Carrying out a requested DV where the Claimant is a Hospital In-
patient 43
10.10 Retention of notes containing claimant’s details 45
11. Recommended approach to Disability Assessment 46
11.1 Comparison of role of Clinicians and Disability Analysts 46
11.2 Disability analysis in DLA/AA 47
11.3 Definitions of disability and impairment 47
12. Completion of reports 48
12.1 Introduction 48
12.2 Recording information from the claimant 49
12.3 Physical examination in HCP assessments 58
12.4 Mental state examination 60
12.5 Your opinion 60
12.6 The assessment of mobility 61
12.7 The assessment of care needs 63
12.8 Epilepsy Questionnaire 65
12.9 Functional prognosis 65
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12.10 Variability of conditions 65
12.11 Unexpected findings (see Appendix E) 68
12.12 Harmful, embarrassing and confidential information 68
12.13 Personal descriptions in medical reports 69
12.14 The assessment of Chronic Fatigue Syndrome (CFS) / Myalgic
Encephalitis (ME) 72
13. Risk management for the HCP 74
13.1 Potentially aggressive situations 74
13.2 Audio or visual recording of assessments 75
13.3 Taking of notes during an assessment by the claimant or their
companion 76
14. Assessing quality of service 78
14.1 Claimant satisfaction 78
14.2 Integrated Quality Audit System (IQAS) 78
15. Complaints 81
15.1 Definition of a complaint 81
15.2 Why are complaints important? 81
15.3 The complaints procedure 81
15.4 Customer Relations Team (CRT) 83
15.5 Complaints and the HCP 83
15.6 Escalation of a complaint 86
15.7 Independent Tier 86
15.8 Serious Complaint Investigation Team (SCIT) 87
Appendix A - Atos Healthcare Professional Standards 89
Personal Conduct 89
Appendix B - Professional Standards - Disability Living Allowance and
Attendance Allowance 92
Appendix C - Attributes for assessments in DLA/AA 93
Definition and interpretation of generic attributes 93
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