Archive for November, 2014

The role of observation in the Personal Independence Payment assessment

An aspect of the Personal Independence Payment (PIP) assessment that is sometimes misunderstood is how informal observations are taken into account. The PIP Assessment Guide, produced by the Department for Work and Pensions (DWP), is very explicit about this (we have included the relevant extract at the end of this blog post).

Why do observations form part of the Personal Independence Payment assessment?

The role of observation in the Personal Independence Payment AssessmentInformal observations form part of the PIP assessment because they can add to the information that is available to the HP for them to be able to provide a report to the DWP. They may, for example, indicate that you have problems that you haven’t referred to elsewhere, or give a clearer indication of how you are affected by certain aspects of your disability or illness. It is important to remember that PIP is concerned with your needs as a result of your disability or illness, rather than the disability or illness itself.

Observations will only be made by the HP while they are with you during a face-to-face consultation. They won’t be made through things such as CCTV or observation of the car park through a window. They also won’t be done by anyone other than the HP, such as a receptionist.

How observations are used in the Personal Independence Payment assessment

If you are observed to do something by the HP it does not mean that they will assume that you can always do that. The PIP assessment takes into account that some conditions can fluctuate, and that whether you can do something reliably is important. We have covered on this blog previously both how fluctuating conditions are handled under PIP and how the reliability criteria are applied.

HPs will always consider informal observations in the context of fluctuations in someone’s condition. However, if the observations are inconsistent with what has been claimed in the ‘how your disability affect you’ form then the HP will have to use their judgement about what weight to apply to them.

We know that some people are advised by others to explain how they are affected by their illness or disability as if every day is like their worst. If you say in your ‘How your disability affects you’ form that you can never complete a particular task, but you are then seen doing so by the HP, this may be viewed as inconsistent. If your condition fluctuates you are always better explaining how it fluctuates in terms of things like good days vs bad days per week or per year.

Extract from the DWP PIP Assessment Guide, 27th May 2014

Informal observations

  • 2.6.24. Throughout the consultation, the HP should be making informal observations and evaluating any functional limitations described by the claimant. Informal observations start from “meeting and greeting” (where HPs may be able to observe the claimant’s appearance, manner, hearing ability, walking ability) and continue throughout history taking. The claimant’s mood, powers of concentration and ability to stand, sit, move around freely and use their hands should be observed. They may also be observed performing activities such as bending down to retrieve objects such as a handbag on the floor beside them, or reaching out for an object such as their medication.
  • 2.6.25. HPs may note how claimants stand and mobilise to any examination couch and observe the ease with which they get on and off the couch. How does the claimant remove their clothes or shoes? Informal observations should be recorded in the report, for example: “I observed the claimant… and they appeared to have no difficulty with…”; “I saw the claimant lean heavily on a walking stick to cover the distance to the consulting room”.
  • 2.6.26. The HP should note any aids or appliances in evidence, such as a walking aid, and the extent to which they are used during the consultation. Aids are devices that help a performance of a function, for example walking sticks or spectacles. Appliances are devices that provide or replace a missing function, for example artificial limbs, wheelchairs, or collecting devices for stomas.
  • 2.6.27. The HP’s informal observations will also help check the consistency of evidence on the claimant’s functional ability. For example, there is an inconsistency of evidence if a claimant bends down to retrieve a handbag from the floor but then later during formal assessment of the spine, declines to bend at all on the grounds of pain or if the claimant states that they have no mobility problems but they appear to struggle to walk to the consulting room. In deciding their advice, the HP will need to weigh this inconsistency, and decide, with full reasoning, which observation should apply.


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Atos Healthcare’s role in the delivery of Personal Independence Payment

Personal Independence Payment (PIP) has been designed by the Government to help with some of the extra costs associated with long-term ill health or a disability for those aged between 16 and 64. It has been introduced as a replacement for Disability Living Allowance (DLA). The Department for Work and Pensions (DWP) have overall responsibility for PIP, and directly manage the claim, decision making and payments part of it, as well as the overall policy that sets out how it works. The assessment part of the PIP process, which happens when you first claim PIP as well as periodically while you receive it, is managed by assessment providers, one of which is Atos Healthcare (we cover Scotland, the north of England and the south of England including London).

The role of the PIP assessment provider

As an assessment provider it is our job to provide an independent assessment of the impact that a claimant’s health condition or disability has on their daily life. The report we provide for DWP for any PIP claimant has to be objective and unbiased. Each assessment report is produced by a Health Professional qualified in disability assessment. They could be Nurses, Physiotherapists, Occupational Therapists, Doctors or Paramedics.

The information used to write the report could come from various places, such as:

  • your completed ‘How your disability affects you’ form
  • Any other relevant information you provided with your form
  • Information that we ask for and receive from people involved in your care,
  • A face-to-face consultation with you (if the other information isn’t enough).
  • Information provided by DWP

All this information is considered by the Health Professional so that they can provide a report to the DWP decision maker that explains what it all means in relation to the PIP criteria (also known as the descriptors). The decision maker uses the report along with the rest of the information to decide whether the PIP criteria are met and, if so, to what extent, so that they can make an award.

How do we fulfil our role?

Atos Healthcare is responsible for the assessment phase. This includes all of the administrative tasks (such as receiving referrals from DWP, moving them along the different stages, issuing letters to claimants and requesting information) and the assessment itself (including the face-to-face consultations and paper based reviews and reports). We work closely with DWP to ensure that any changes that DWP make to the policy are reflected in the way we are carrying out the PIP assessments. DWP also set targets for us in areas such as quality of both service and reports and the time within which we should provide them with a report after they have sent a referral to us. However, we don’t have any targets relating to the type of advice we provide or the decisions that DWP ultimately make on claims.

You can find more detailed information about the different parts of the PIP assessment process for our areas on our website, as well as by looking at other blog posts here.  The infographic below might also help you to identify who you need to contact with any questions that you might have.


Personal Independence Payment: Who to contact with questions. Click to enlarge

A version of this infographic with audio description is available on our YouTube channel

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