Select Committee on Social Security Minutes of Evidence


Executive summary of report by Ernst and Young

  This is the report of a joint Ernst and Young and War Pensions Agency (WPA) Team which undertook a high level review of the end to end decision making and appeals processes attaching to war pensions.

  We found that the average time taken to process a claim for War Disablement Pension, where there is a need to seek evidence before a decision could be made, was 124 days and that appeals take on average 343 days where further evidence is required and 233 days where no further evidence is required. These averages mask a considerable range.

  In addition to issues around the time taken to process cases, we found some concerns about the level of service provided to claimants and appellants in terms of the support they received in making claims and in being notified of decisions and progress.

  There is a complicated web of reasons for these problems. The fact is that the current War Pensions Scheme has seen little change since 1946, whereas most other Social Security legislation has benefited from modernisation at the least during that period. The Scheme is deliberately generous to claimants, is loosely worded and relies on a curious mixture of discretion and medical decision taking and aetiology. It is not surprising therefore, that over the course of the last 50 years a body of practice has grown up around the scheme that to some degree gets in the way of its efficient and effective operation.

  We have concentrated on identifying a package of opportunities for improvement that works with the scheme in spirit as well as in letter, but which, in effect, pares the operation of the scheme back to its basic constituents. In particular, we have tried to refocus the operation of the scheme on the individuals making claims under it. This is consistent with the Government's general reorientation of the welfare community to be more customer focused.

  We have identified improvement opportunities which together could reduce the end-to-end process times significantly.

  The average PAT clearance time is currently 298 days but this is skewed by the current focus on clearing backlog cases. The PAT anticipate reducing their processing time to 14 weeks (just over 70 days) by April 2000. The opportunities identified by this review will help these targets to be achieved.

  In addition, our portfolio of opportunities will significantly improve service to the customer, primarily by making transparent where an individuals case has got to, who is responsible for what at each stage of the claims lifecycle and by providing support at the claim application stage.

  Our proposals can be grouped according to those that impact primarily business processes and targets, those that require a change in policy and/or legislation and those which are geared to addressing some of the "cultural" problems currently affecting the DMA process.

  As far as processes and targets are concerned, the introduction of a workflow package will enable work to be managed in a systematic way across case-working teams whilst reflecting Ministerial and Agency priorities. It will also provide much greater visibility of where a case has got to and who is responsible for what action in relation to each case at any given time. It will support managers at all levels in reducing the time lost due to files waiting in racks for the next task to be performed. It will provide better, easier to use management information, enabling problems to be identified more quickly and best practice to be shared more easily.

  This enhanced control will also support the new performance measures and targets which we recommend ought to be introduced. The current targets tend to work perversely. They encourage bunching around key milestone dates and cause cases which have missed the Secretary of State targets to be delayed excessively whilst not encouraging speedy decision taking even where that is possible. New measures and targets should be designed to enable a more balanced performance regime and to identify areas of difficulty wherever in the end to end process they occur.

  Key to the process changes is the premise that both claims and appeals can be divided into those that are straightforward, which should meet more aggressive targets, and those that are complicated either through the conditions themselves or new evidence or new contentions arising which have to be addressed. The claims form could be changed to state that, for example, 75 per cent of claims will be cleared within 95 days but that submitting additional evidence or new conditions may result in it taking longer. This will place some of the onus of meeting the time targets onto the claimant.

  The appeals process could be changed to give a very clear definition of what comprises an appeal, i.e., disputing the decision given at the claim stage, with clear time limits (for example, six months) within which to lodge an appeal. If the "appellant" submits further evidence or requests that an additional condition be considered then this is no longer an appeal but a review and this will be dealt with through the claims process. If the "appeal" is requested outside the six month time limit it will not be heard except in very exceptional circumstances. Instead, the appellant will have the right to have his case reviewed where new evidence is presented. This will clear the way for an aggressive target to be placed on the appeals process within the WPA of 28 days to produce the Statement of Case (SoS), followed by 28 days for the appellant to comment on his Statement of Case. Any comments will be submitted to the PAT along with the SoC.

  These considerable policy adjustments will need to be balanced by process and cultural changes if they are to be effective. Much better support will need to be given to the claimant in making their claims. This should take a number of forms. In the short term, an enhanced help-line facility would contribute whilst the Agency reviews whether its welfare service should not be actively helping claimants building their claims. The claims forms themselves and the supporting "marketing" material should be redesigned so that claimants are aware this is in their best interests to provide as much information as they can. They might especially be encouraged to include a diagnosis of their condition, wherever possible. The aim would be for this diagnosis to be fit for the purposes of the scheme so that the Agency doctors could simply "admit" the diagnosis at the start of the process. This should reduce the need to seek additional medical evidence in at least some cases.

  The PAT should assume responsibility for the active management of appeals cases and would have to account for the time taken from the lodging of an appeal with them to the final decision having been made.

  Finally, we believe that there are great benefits to be garnered by an aggressive project designed to foster a common understanding and corporacy amongst as many organisations as possible. In particular, we see merit in the development of core foundation training for all new WPA staff, to clarify the history of the scheme and the operating context, the roles and responsibilities of the key players, what decisions need to be taken, by whom and on what basis and so on. The wider the spread of organisations that participate in this foundation training the better.

  A formal programme needs to be set up within weeks to drive these opportunities through to implementation.

7 May 1999


 
previous page contents

House of Commons home page Parliament home page House of Lords home page search page enquiries

© Parliamentary copyright 1999
Prepared 23 June 1999