NHS trust, regulator and Atos all apologise over nurse’s dishonest PIP assessment

An NHS trust, the nursing regulator and a government contractor have all been forced to apologise over their failure to carry out proper investigations into a nurse who dishonestly assessed a disabled teenager’s eligibility for personal independence payment (PIP).

The Nursing and Midwifery Council, Atos* and Lancashire and South Cumbria NHS Foundation Trust have all apologised to the teenager’s family over their failings.

The case, which saw the teenager stripped of her benefits, has again highlighted the flaws at the heart of the PIP assessment system and the continuing dishonesty of many of the healthcare professionals who carry out the face-to-face tests.

But it also highlights again the failings of the organisations at the heart of the system, and those that regulate their staff, such as NMC.

And it raises concerns about the involvement of NHS organisations in the controversial and much-criticised assessment process.

The teenager’s father, David**, has spent more than three years seeking justice after witnessing – and secretly recording – his daughter’s assessment.

The subsequent assessment report, he says, was littered with errors, inaccuracies and fabrications.

He eventually submitted more than 50 complaints about the assessment and its aftermath.

The nurse who carried out the assessment claimed it lasted 48 minutes, when in fact she rushed through it in just 19 minutes.

She had arrived at the assessment in August 2017 armed with nothing but a single sheet of notepaper.

David’s daughter, Paula**, had been claiming disability living allowance at the higher rate for care for 10 years, but the dishonest assessment led to the Department for Work and Pensions (DWP) finding her ineligible for PIP.

She was so damaged by the experience that she has refused to go through the assessment process again and has resigned herself to coping without the financial support she needs to help her through university.

In David’s complaint to the Independent Case Examiner (ICE), he said that Atos’s response to his concerns about the assessment had been “full of lies”.

After carrying out an initial investigation and listening to the secret recording of the assessment, ICE has now persuaded Atos to apologise and pay the family £150 compensation.

In its letter to David, ICE said: “The recording appears to show that the assessment lasted approximately 19 minutes, there were no explanations at the start of the assessment from the HCP [healthcare professional] as to the purpose of a PIP assessment and the format it would take, the HCP did not ask about [Paula’s] ability to follow or plan a journey, or about current medication and did not explore information about a bad day – rather she focused on gathering information on a good day only.”

Atos has now apologised to David for how it handled his original complaint and for “the poor service we have provided”, and admitted it was “somewhat concerning” that the nurse had failed to discuss “planning and following a journey”.

The Atos PIP client relations officer admitted this was a “vital piece of the PIP consultation”.

An Atos spokesperson this week refused to answer questions about the case, including whether the nurse was still carrying out PIP assessments on its behalf.

The nurse had been working for Lancashire and South Cumbria NHS Foundation Trust (LSCFT), which had been sub-contracted by Atos to carry out PIP assessments for five years.

The trust has now apologised to David for the “distress” caused both by the assessment and its subsequent botched investigation into his complaint, which it said had led to a “comprehensive review” of its complaints process.

But it also claimed that it could not carry out a proper review of its original investigation into the nurse’s assessment because all the staff involved, including those who investigated his complaint, had now left the trust, “along with the records relating to the cases and the guidance the staff had worked to”.

A trust spokesperson said this week: “We accept that the review did not meet the standards we expect and are sorry for the distress caused to the service user and their family. This should not have happened.”

He said all the information about its PIP assessment services had been transferred to a new provider when the trust ended the contract in July 2019, after five years providing PIP assessments.

Asked if the nurse was still working for the trust, he said: “We are unable to make comment about staff members, past or present, without compromising confidentiality.”

David said he was also appalled by the way the Nursing and Midwifery Council (NMC), which regulates nursing, dealt with his complaint about the nurse.

In January 2018, NMC wrote to David to say that it had decided not to investigate his allegations any further after talking to Atos and LSCFT, because of a lack of “sufficient credible evidence”.

He subsequently provided further information to NMC, which has now admitted that “something went wrong” when it carried out a preliminary screening of his complaint, and that its decision “did not consider all of the concerns raised by [David] in his referral”.

NMC has now decided to carry out further enquiries into his complaint.

David told Disability News Service: “My daughter has given up on PIP and says she will never ever apply for anything like it again after what she has gone through.

“I can clearly see evidence of collusion between all agencies to protect nurses who are producing deliberately false PIP assessments.

“I think there is a fear that if they allow a nurse to be struck off for a poor PIP assessment it will open the floodgates and, with hundreds if not thousands of NHS nurses involved, it could damage the NHS.”

He said NMC had been “hell bent” on proving that his allegations were unfounded.

He added: “I can fully understand why people simply give up trying to get justice for their incorrect assessment.”

David also passed his concerns to the Professional Standards Authority (PSA), which oversees the work of health and care regulators.

A PSA spokesperson said this week that David was “one of a number of members of the public who raised concerns with us about the NMC’s approach to complaints about registrants conducting PIP and other disability benefit assessments.

“His valuable feedback contributed to our decision to conduct a targeted review of the NMC’s cases involving similar complaints.”

The PSA subsequently concluded that there had been widespread mishandling by NMC of complaints it had received in 2017-18 about the way nurses carried out disability benefit assessments.

The PSA spokesperson added: “We will continue to monitor the NMC’s overall performance in these areas and [David’s] complaint provides valuable information for us in that work.”

The previous year, PSA also concluded that there were “issues of concern” over the way the Health and Care Professions Council dealt with similar complaints about how physiotherapists and paramedics carry out PIP assessments.

DNS spent months investigating allegations of dishonesty by PIP assessors in late 2016 and throughout 2017, hearing eventually from more than 250 disabled people in less than a year about how they had been unfairly deprived of their benefits, with such cases still continuing to come in nearly four years after that investigation began.

Emma Broadbent, NMC’s director of professional regulation, said it was sorry for its failings with David’s and other complaints about PIP assessors.

She said: “We are reviewing the information provided by [David] and will remain in touch with him to ensure he’s informed about any further action that we take. We are unable to comment further at this stage.

“We have taken steps to fully address the issues raised about our decision-making process for PIP-related concerns.

“Since 2018, we have reviewed our procedures and made changes to improve the process.

“These changes have included new quality assurance checks for PIP cases, additional support materials for our investigators including information about the DWP benefits process and practical guidance on how to investigate PIP cases.”

*Atos delivers its PIP assessment contracts through Independent Assessment Services, a trading name of Atos IT Services UK

**Not their real names

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