Tuesday, 6 September 2011

Atos - University Accreditation in "Disability Analysis"

The latest announcement from Atos Healthcare could be perceived as a rather cynical bid to add credibility to the contentious health exams it carries out for the DWP.

The subsidiary of French IT firm Atos Origin has joined forces with University of Derby - Corporate to accredit training for Atos Nurses. Their Certificate of Achievement - Disability Analysis will give Nurses 30 of 120 credits required for a BSC (Hons) in Nursing.

Mike O'Donnell, CMO (Chief Medical Officer) at Atos Healthcare: "Training is absolutely critical in a professional organisation in order to stay abreast of latest developments and ensure consistent high quality services for clients. At Atos Healthcare, we take training very seriously and we are very proud that our training course has been recognised and accredited by the University of Derby.

"In addition to the induction training for all our healthcare professionals, we run ongoing training events and mentoring programmes to ensure our healthcare professionals have the knowlege and tools to do the best job they can for our clients."

As part of the assessments, a Derby tutor will visit Atos Healthcare training centres nationally and assess all aspects of the disability assessment training courses, including the Observation of Simulated Client Experience (OSCE) and reports based on actual assessments. The tutor will assess and evaluate if the tests are meeting the accepted standard for accreditation. Successful nurses will then be awarded the University of Derby accredited award.

Source: University of Derby - Corporate 

The London School of Economics, along with many Disability Charities and Campaign Groups, continues to expose the failures of existing "disability analysis" processes as well as ill-considered proposals in the Welfare Reform Bill. In a May 2011 article for LSE, Debbie Jolly of Disabled People Against Cuts (DPAC) makes the factual point that "the government’s Work Capability Assessment for disabled people is one of the toughest in the world and is not fit for purpose." This continues long after Professor Malcolm Harrington, himself an Occupational Health Specialist, said much the same in his post-investigation "damning report" slamming the process which was published in late 2010.

Needless to say, criticisms of the existing system were in the public domain since before it was unleashed in 2006. At the heart of these is the reality that the LIMA computer system developed & implemented by Atos is the tool of choice for Atos Medical "Professionals", including its nurses.

It is currently against the law to use anyone other than a doctor approved by the Secretary of State to carry out incapacity benefit medicals. However, the DWP has agreed to allow ATOS to use 'other Healthcare Professionals (HCPs) such as nurses' to carry out examinations 'in other benefit areas - provided that they follow appropriate EBM [Evidence Based Medicine] protocols and are supported by LiMA'. LiMA (Logic integrated Medical Assessment) is the software developed by Atos primarily to carry out incapacity for work medicals.

The DLA and AA nurses will begin work in early 2006. The most likely area of involvement is disability living allowance assessments for which LiMA software is already being piloted in the Bootle and Manchester areas. The DWP are making determined - and unlawful - efforts to keep the information on this software secret. What is clear, however, is that as with the LiMA incapacity software, the ultimate aim is to reduce most of the assessment to a series of easy to answer questions which require no medical knowledge. (For more on LiMA and its use for DLA assessments see: DLA winners and losers: leaked document reveals radical new assessment system)

It should be noted that the computer led nurses will be no ordinary nurses, they will in fact be from Atos Origin's own pool of existing occupational health nurses. In other words, they will be full-time employees whose loyalties are entirely to Atos and who are accustomed to working towards getting employees of large corporations back to work. Claimants who are invited to attend at an MEC for a DLA or AA medical will need to think carefully about whether they should exercise their right to insist on a home visit. On the one hand Atos nurses will probably have very little experience of the benefits system or of working with claimants. On the other hand, computer led medicals carried out by Atos nurses may be easier to challenge at appeals, particularly if claimants have evidence from their own GP or consultant to put in its place.

Source: Benefits & Work Archive, Nov '05

GP Mary McCartney sensationally added to the Atos maelstrom with her British Medical Journal feature "Well enough to work" in which she investigated the ethics and fairness of the disability assessment process.

Atos chose not to be interviewed by the BMJ , although the Department for Work and Pensions referred me to the organisation for questions about recruitment, training, and audit that it couldn’t answer.

However, from the recruitment evening it was clear that the medical examination consisted of a computerised form to be filled in by choosing drop down statements and justifying them. For example, you could say “able to walk with ease” if you witnessed this or the patient told you this.

The professional role of the doctor is very different from that in the typical NHS. Paul Nicholson, chair of the BMA Occupational Medicine Committee, says that working in this environment brings specific difficulties. “Notwithstanding a contractual obligation to provide a report to a government department, I still have a professional duty of care to the patient and to make the care of the patient my first concern.”

The Faculty of Occupational Medicine publication Good Occupational Medical Practice reinforces the General Medical Council’s position that, good medical care “must include adequately assessing the patient’s conditions, taking account of the history (including the symptoms, and psychological and social factors), the patient’s views, and where necessary examining the patient; providing or arranging advice, investigations or treatment where necessary; referring a patient to another practitioner, when this is in the patient’s best interests.”4

In other words, it expects doctors to adhere to the same professional conduct as they would in any other role.

Source: British Medical Journal

It seems that the duty of Atos medical professionals towards claimants or customers (never patients) ultimately takes a back-seat to government interests, with or without University of Derby - Corporate Atos-approved Accreditation. Though it has to be said; given the legitimate factual concerns about the IT-turned-Healthcare service provider and its processes, this latest incestuous bid for disability credibility with government and corporates is in and of itself deeply worrying.

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  1. Derby University? One of the worst in the UK. When I was there briefly, it was #96 of 96...

  2. Has the NMC and the Royal College of Nursing made any comments over the role of nurses in ATOS assessment or the course that Derby is accrediting. There is likely to be similar professional concerns mentioned by the BMJ Doctor concerns under the NMC 2008 Code of Practice for the nursing.

    As a patient I am not going to be confident in a University of Derby BSc Nursing graduate if they updated their Dip through a course like this. Going off to look at the University of Derby pin badge on Google so I know what to look out for.

  3. Maybe this will damage Derby's nursing dept's academic reputation. I'm not sure if they have one, mind you.

  4. I tweeted this post to them. No response. No response from media, MP .... Etc either.

  5. They may as well be off the chart with this debacle..

  6. I'd never heard of them... And this isn't making me think well of them in the slightest..

  7. [...] Atos – University Accreditation in “Disability Analysis” (thecreativecrip.com) [...]