Veterans UK Launch Pilot Scheme to Ease Pressure on the NHS but Avoid Improvements for Mental Health Claims
Veterans UK has launched what they see as a pilot scheme that seeks to ease the pressure on the NHS by changing the way they gather medical evidence for War Pensions Scheme claims and reviews.
Whilst any ideas that improve the way medical evidence is sourced is to be welcomed, Veterans UK has missed another obvious chance to help those servicemen and women who are claiming for mental health conditions.
Easing the burden on the NHS
In their latest press release Veterans UK highlights their efforts to [Quote] “obtain all the relevant medical information with the least added pressure for the NHS” [Unquote]. They have decided to cease issuing requests for medical board examinations or hospital case notes. Instead they will be issuing a ‘Primary Care Factual Report’ and a ‘Supplementary Self-Assessment’ form directly to the claimant. This will be accompanied by a letter that will apparently explain everything and provide instructions for the claimant to follow. This ‘slightly’ re-designed Primary Care Factual Report can be completed by either a GP or a GP Surgery Practice Manager.
Will the new scheme actually work?
Having worked as a Senior GP Surgery Practice Manager for 10 years with responsibility for a large GP Practice of 18,500 patients, I take the view that this pilot scheme is going to create as many problems as it seeks to resolve.
Veterans UK believes that [Quote] “in a small number of cases the GP may ask the claimant to attend the surgery prior to the completion of the form” [Unquote]. I do not know what research they’ve done to take this view, but in my experience GPs will not have the time to sit and wade through many years of medical notes, particularly for War Pension Scheme claims where the injury, illness or condition may go back many years, and GP Practice Managers are simply not qualified to complete these forms.
This new pilot scheme might remove the burden of requesting hospital medical notes but very often what is contained in the hospital records is not duplicated in the GP records. Whilst, as Veterans UK believe, they should be able to complete the relevant sections using treatment notes held on their records, they have missed the fact many GP Practices will not hold notes that were originally held at the various hospitals. Historically, hospital IT systems have been unable to connect with GP Practices, save for the implementation of electronic test results from hospitals to GP Practices, and this will result in GPs still having to write to hospitals for notes.
Transferring the burden
What this pilot scheme certainly will achieve is a transfer of the burden from secondary care to primary care at a time where there is an acute shortage of GPs, and those who remain in primary care have even less time to see their patients, let alone complete Primary Care Factual Reports.
We know from experience that for many of our clients the completion of the Primary Care Factual Report will be as difficult as completing the AFCSWPS0001 application – and will be beyond the ability of many. We also know that many claimants will receive this Primary Care Factual Report form, take one look at it, and tuck it away in a drawer hoping that it will miraculously complete itself!
What about mental health claims?
We are always in favour of a new initiative that will help servicemen and women to seek the compensation they truly deserve, but we feel that a much more beneficial scheme would be one that helps those claiming for mental health conditions.
At the moment Veterans UK insists that the medical evidence required to support a claim for any mental health condition must include a diagnosis of that condition, which must be made by a clinician at Consultant grade. A diagnosis made by Senior Registrar, a Senior Counsellor in mental health or even an experienced GP specialising in mental health is not accepted as appropriate evidence and this simply allows Veterans UK to decline hundreds of applications on a technicality.
Furthermore, Veterans UK adds insult to injury for these claimants by reminding them that unless they provide the evidence required within 3 months, signed by a Consultant Psychiatrist or Consultant Psychologist, they will close the claim. No pressure on the claimants then, at a time where securing a referral for a first consultation with such a consultant is measured in terms of several months. Perfect timing for Veterans UK to decline a claim on a technicality!
We have made a formal approach to the Secretary of State for Defence, through our Member of Parliament, to seek an explanation for why the diagnosis of PTSD, for example, must be made by a Consultant. At the time of writing this Blog we are still waiting for Mr Ben Wallace to respond.
Consultant grade clinicians are in short supply; they are overworked, and many may have never been involved in the specific assessment, diagnosis and treatment of an individual patient suffering with mental health. Despite this, the experienced Registrar or Senior Mental Health Counsellor, who may have been instrumental in the treatment of a patient, often over many years, does not have the authority to confirm a diagnosis of mental health that is acceptable to the Medical Advisers at Veterans UK.
If Veterans UK wants to introduce an initiative that will really help servicemen and women, they could relax the regulations, free up time for overworked Consultants, and make the progress of a claim for mental health easier and less traumatic for the claimants.
Wouldn’t that be a really good Pilot Scheme?