Decision makers question just 1 in 40 Atos Healthcare ESA medical assessments

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Decision makers question just 1 in 40 Atos Healthcare ESA medical assessments

Some decision makers felt forced to 'rubber stamp' Atos advice says new DWP research report


Decision makers are questioning just 1 in 40 Atos Healthcare Employment and Support Allowance (ESA) medical assessments, according to new Department of Work Pensions (DWP) research.

The research report, 'Decision making on Employment and Support Allowance claims', sets out the findings of the small scale research. The aim of the research was to understand more about how decision makers make judgements in ESA cases where they potentially face conflicting evidence, or where it may be debatable which outcome should be awarded, these are known as ‘borderline cases’.

The research follows the recommendation made in the Harrington Year 1 Review of the Work Capability Assessment (WCA) to empower decision makers to take ‘an independent  and considered decision’, based on all the evidence provided and not just follow the advice and evidence coming out of the Atos WCA assessment.   The DWP research showed that all Decision Makers were aware of this recommendation.

The research involved ten group discussions with Decision Makers across five Benefit Centres and ten in depth interviews with Atos Healthcare Professionals (HCPs) responsible for conducting Work Capability Assessments (WCAs), which took place in September and October 2011. The research explored overall views on the role of the Decision Maker and the types of cases. 

The research finds that despite an initial movement towards greater empowerment of decision makers, by the time of the research, many felt the guidance they had been given gave them less control over decision-making:

‘Some felt that they still had some ability to reach their own decision over borderline cases where they disagreed with the Atos advice while others felt limited in this respect. In the latter group were those who felt they had been expressly told that they could not make a decision that ran contrary to the Atos advice without securing Atos agreement to this, which they had found Atos reluctant to provide).’

The report also says that, for most decision makers, the WCA report compiled by Atos was considered to be the main piece of evidence when assessing a case and in the majority of these cases, the advice given by Atos in this report was followed.

Where decision makers felt there was evidence that ran against the advice in the WCA report, they could either choose to raise queries with Atos and ask healthcare professionals to review the case, or they could choose to change the points allocated. In cases where Atos did not agree with their suggested amendments the decision makers felt they were forced to ‘rubber-stamp’ a decision that they were not satisfied with. 

Research Report 788, Decision making on Employment and Support Allowance claims, is available from the DWP website.

The Independent Review of the Work Capability Assessment 2010 is available at:

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