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
|