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This website provides information on how Atos runs its business, extracts from the Contract between the DWP and Atos including the MEDICAL CONDITIONS that mean a face to face medical assessment is not always necessary, ASSESSMENTS AND POINTS, the breaches of Contract that occurred in my case, my unsound medical report and the correspondence showing how difficult it is to obtain justice or advice.
The Government is inviting the public to submit petitions. Search epetitions.direct.gov.uk for "DWP" or "Atos" or "disabled" to list relevant petitions including Stop and review the cuts to benefits and services which are falling disproportionately on disabled people, their carers and families (http://epetitions.direct.gov.uk/petitions/20968).
Other ongoing petitions are Petition against constant vilification of sick and disabled claimants and Petition to "Sack Atos Immediately" .
The DWP occasionally consults the public http://www.dwp.gov.uk/consultations/.
This is the report that was eventually produced. The legality of this report is still disputed.
Extract of letters from the Convenor to the Independent Tier who reports that investigations have been completed. The cover letter has attachments comprising a part which considers the administrative handling and a part which considers medical issues and concentrates in the main on the medical report.
It should be noted that the medical report uses the correct term "claimant" and the other parts use the terms "customer" and "client".
Atos Healthcare reputation for poor quality is confirmed in that a reference is made to a letter dated 2019, a reference is made to the Department "of" Work and Pensions , a reference was made to a letter sent to the "Client" whoever that might be, a reference was made to the Incapacity Benefit and other errors.
Though reference is made to Statutory and Regulatory Instruments the important matter of multiple breaches of the Contract between the DWP and Atos Origin IT Services is not referenced. The fact that Atos Healthcare has agreed that the ESA report is unsound medically is not referenced.
The BMA comment is partial. Here Atos Healthcare have agreed that they are in breach of the Contract and despite their assurances to the Minister the ESA information was not processed by a qualified medical practioner in deciding whether a face to face interview was necessary. The incompetence of Atos Healthcare is emphasised in that they are not able to identify the individual involved. It is difficult to believe that Atos Healthcare have such a poor approach to audit and record keeping. I suggest the BMA has concerns at Atos Healthcare using unqualified employees to take medical decisions in respect of whether a face to face assessment is required.
A patient is not in a position to decide about terminal illness.
At the time of the assessment I had no access to the Contract which states that the medical practitioner must be a specialist in the pathology and treatment of the medical condition or refer to the patient's GP and or Consultant. My GP has stated time and again he is not able to treat me as I need a specialist Neuro-surgeon and Neurology. Dr Ludmila Semetillo should have followed GMC advice and not carried out the assessment. The fact that she did, constitutes an assault as defined in the Contract. Dr Ludmila Semetillo asked questions and carried out a few simple tests. The fact that a doctor is able to carry out an examination is irrelevant. The Contract defines when an examination conforms to rules and when it does not. Dr Bruecker knew that he would be in breach of the Contract if he carried out an examination without information from the GP and Consultant. His evidence will be put forward to the GMC. I have been told that other Atos Healthcare doctors who have stated to the patient that they are not qualified to carry out the examination and have ceased immediately the assessment. It appears to me that Dr Ludmila Semetillo was unprofessional and is guilty of misconduct. A similar case can be made against the Mrs Tanya Catherine Andrews the nurse. She should not have forwarded the matter to the doctor.
Atos Healthcare has not provided information through a freedom of information request that Mrs Tanya Catherine Andrews or Dr Ludmila Semetillo has passed the Atos training. This is damning of Atos Healthcare.
It shows the Atos Healthcare slip shod approach to quality when they cannot get such an important investigation correct. It beggars belief that Atos Origin IT Services can be used for Government projects.
Dear Mr B..., I am writing in my capacity as Convenor to the Independent Tier (IT), to inform you that the IT has now completed their investigations. I have copied the findings from the IT, which comprises an assessment about how the complaint has been handled by Atos Healthcare and also an assessment of the medical advice provided to the Department for Work and Pensions- In respect of the administrative handling the IT have commented on: - The specific issues of your complaint - The investigation conducted - The response provided - The outcome provided - The tone of the correspondence From Medical Services - The complaints process As you will see Atos Healthcare has been supported by the Independent Tier in our handling of the complaint. An independent medical practitioner, trained in disability assessment medicine has also provided an assessment relating to the quality of the relevant medical report relating to your complaint. The independent medical practitioner has confirmed that the medical report is completed in accordance with Atos Healthcare's professional and quality standards. I can confirm that both assessments oF the Independent Tier have been forwarded to the office dealing with your claim in Jobcentre Plus. This now concludes the Atos Healthcare complaints process; if you have any further queries you may contact the Chief Executive of Jobcentre Plus at the address below: Jobcentre Plus Jobcentre Plus Chief Executive, Room 608, Caxton House, Tothill, London SW1H 9NA Atos Healthcare aim to provide a professional, fair and courteous service to all customers who undergo medical examination in connection with a claim for benefit. On behalf of Atos Healthcare please accept my sincere apologies for the inconvenience and upset caused to you on this occasion and I hope that any further dealings with our service will not give you cause for complaint. Yours Sincerely Geoff Hampshire Convenor to the Independent Tier
Page 1 of 4 FILE NUMBER 432 INDEPENDENT TIER FEEDBACK REPORT Ref: Atos Healthcare Complaints Procedure MED-CPO1 version 4 This report covers the way the Complaint was handled (As explained in the Convenor's letter of 18 January 2019 to the Customer, the remit of this element of the Independent Tier is to assess whether Atos Healthcare has adhered to the agreed complaint process). It is custom and practice for the term "Customer" to be used to describe the individual who has lodged the complaint. SPECIFIC issues identified: This complaint related to the circumstances surrounding a medical examination conducted on 24 July 2009 (the Customers letter was dated 29 July). This letter raised 9 issues and the Customer also asked when he could expect to receive a copy of the report. (Prior to this the Customer had written a letter (dated 28 June 2009) asking a number of questions related to a medical assessment arranged for the 9 July 2009 that was subsequently cancelled). The letters mentioned above were received by Customer Relations (CR) in Leeds on 10 August 2009. It was clear from the communications the Customer Relations Manager (CRM) sent to the Highgate Site Manager (HSM) and to the Offices where the Customer had originally sent his letters, that she recognised the issues relating to his assessment and the late receipt of his letters by CR. She also addressed the issue regarding his expenses which was covered in her acknowledgement letter of 10 August. It was not evident that the issues relating to items 2 and 5 in his letter of 29 July had been recognised as no action regarding these points was undertaken. He also requested information as to how he could obtain a copy of his medical report. This issue was clearly recognised as he was advised of the action he needed to take in the CRM's response letter of 22 September (it is noted that the opportunity to provide this information was not taken when the CRM sent her acknowledgement letter on 10 August). Further communications were received from the Customer regarding what he considered to be breaches of the Complaints Procedure and he asked for immediate referral to the Independent Tier. It was confirmed to him why this could not be done at this time. On 18 August the Customer requested that the CRM cancel an appointment that Atos Healthcare (AH) had made for him for 24 August. He was suitably advised on this issue on the same day. The Customer remained dissatisfied - his letter of 26 September refers, where he again requested referral to the Independent Tier before due process had been completed - and he raised 8 specific issues. It is clearly evident that AH recognised all these issues as the National Customer Relations Manager (NCRM) provided a response to the Customer Relations Team Leader (CRTL) on 5 of them, pointed out that items 2 and 3 needed to be considered Page 2 of 4 by a Medical Manager (MM) while point 5 should be raised with the Medical Directors Office for further consideration of the suggestion. In the meantime the issues addressed in the Customer's letter of 18 November were recognised, as evidenced by the content of the CRTL's letter of 25 November. The Independent Tier noted that 2 items in the Customer's letter of 29 July 2009 had not been considered but otherwise AH staff had recognised the specific issues. INDIVIDUAL investigation conducted: At the first stage of the investigation the CRM sought information from the HSM regarding the circumstances surrounding the Customer's assessment and contacted the offices to which he had originally sent his letters. This is in line with the Guidance given in the AH Complaints Procedure (although points 2 and 5 were not followed up). At the escalation stage the CRTL primarily elicited the assistance of the NCRM followed by an MM and this again looked reasonable. In the main, the Independent Tier considers that an appropriate investigation had been undertaken. COMPLETE response provided: Having sought feedback from the HSM and the offices to which the Customer's original letters had been sent, the CRM sent a response letter dated 22 September to the Customer covering most of the issues raised (with the exception of 2 and 5). This letter also advised him how he could obtain a copy of his medical report. At the escalation stage the CRTL's response letter of 7 January 2010 addressed all of the points raised by the Customer in his dissatisfaction communication of 28 September 2009. The Independent Tier considers that, on balance, complete responses were provided. OUTCOME provided: On receipt of this complaint a letter of acknowledgement was sent to the Customer advising him that a full investigation would take place and he was also sent a copy of the Customer Relations booklet that explains how complaints are dealt with. There followed a number of communications from the Customer and these were duly responded to. The Customer received an update letter from the CRM dated 4 September that explained that she was currently awaiting comments from the Contact Centre Team Leader. When the CRM had received further information she sent a full response letter dated 22 September to the Customer. This letter identified all those who had been involved in the investigation thus far. The Customer's letter of 26 September 2009 was received by AH on the 30th and this was acknowledged by letter dated 6 October. This explained that his complaint would be reviewed by a Senior Medical Advisor. In his letter of the 26th September the Page 3 of 4 Customer had requested referral to the Independent TieT so the reason why this could not be done at this stage was explained in the CRTL's letter of 7 October. An update letter was sent to the Customer on 11 November in which the CRTL explained that she was still investigating his concerns and was awaiting a copy of his ESA50 from the Department of Works and Pensions. The Customer wrote again on 18 November 2009 and his queries/requests were adequately addressed in the CRTL's reply dated 25 November. It was evident thereafter that the investigation continued apace however it was not until the 7th of January 2010 that a full response letter was sent to the Client. This communication identified the people who had been involved. In response the Customer emphasised his desire that his complaint be forwarded to the Independent Tier. That the complaint had been so referred was confirmed by the Convenor to the Independent Tier who satisfactorily explained its remit in his letter of 18 January 2010. The Independent Tier considers that the Customer was kept suitably advised of the outcome, but would comment that there was an unsatisfactory delay before the final response letter was sent to the Customer. TONE is appropriate: Having read all the communications sent to the Customer by various members of AH's staff, the Independent Tier considers that they were of a satisfactory standard and were easy to follow. The tone was considered to be appropriate to the circumstances of this complaint. COMPLAINT procedure: When Customer Relations (CR) received the Customer's letters of 28 June and 29 July a standard Feedback Pro-Forma was completed and a letter of acknowledgement was sent on the same day. It was not within the control of CR to have responded within 2 days of the receipt of the letters by other locations in the business because of shortcomings elsewhere. Once received by them CR is considered to have acted promptly. The investigation, as described in an earlier section of this report, got underway on the 13th of August. Part of the investigation that followed was to try to establish why the letters had not been forwarded to CR on receipt at their original destination. It was evident that the CRM was, in fact, unable to determine what had been the reasons for these shortcomings that led to this situation. In a further communication (11 August) the Customer requested that his complaint be forwarded to the Independent Tier. Quite rightly, as well as replying to other questions raised, the CRM pointed out that it was not possible to do this until the complaint had been investigated through the stages of the CR complaints process. The Customer, in his communication of 12 August disputed this, regarding his letter of 28 June, as he felt that the investigations had been concluded. He received a response from AH and on 18 August sent another e-mail about an appointment that Page 4 of 4 had been arranged for 24 August, while again mentioning that he had not yet received a copy of the medical report for the examination conducted on 24 July. His questions about the 24 August appointment and his expenses were answered the same day. Regarding the investigation that was taking place, the Customer was updated on 4 September (it would have been appropriate at this stage to have given more information to the Customer - that the investigation was taking longer than expected and was therefore likely to exceed the target of 20 working days - which is, of course, allowed for in the Complaints Procedure). He then received a response letter dated 22 September. This addressed the concerns related to the 2 letters not being received hy CR until 10 August, the journey arrangements, the delayed appointment, the facilities at Highgate MEC, proof of identity, his expenses and how he could obtain a copy of his report. The Customer remained dissatisfied - his letter of 28 September refers - and requested that his case be submitted to the Independent Tier. (It is noted that a number or the issues that he wanted to be considered are outside the remit of this element of the Independent Tier, which is tasked with reviewing how complaints are handled). He received a letter of acknowledgement dated 6 October; this looked to be somewhat tardy however there was an intervening weekend. He received another on the 7th explaining the Rules agreed with the Department for Work and Pensions (DWP) prevented referral to the Independent Tier at this stage and an update letter from the CRTL dated 11 November 2009 explaining that a copy of his ESASO was awaited from the DWP and once this had been received her investigation would continue. Another update letter, which again emphasised at what stage referral to the Independent Tier could take place, was sent to the Customer on 25 November (this was a response to his communication of 18 November). The full response letter was sent to the Customer on 7 January 2010 and considering the time that had elapsed since AH's previous communication, the Independent Tier feels that a further update prior to the sending or this 7 January would have been warranted. Following receipt of a further dissatisfaction letter from the Customer, his case was duly submitted to the Independent Tier for review. In the main, the Independent Tier considers that the complaint was handled in line with Procedure. One or two shortcomings were noted however, on balance, in this instance the Independent Tier considers that Atos Healthcare is FULLY SUPPORTED MJS for the Independent Tier 3 February 2010
Page 1 of 7 To: Geoffrey Hampshire Convenor to the Independent Tier Atos Origin Medical Services Wing G, Block1 Government Buildings, Otley Road, Lawnswood, Leeds LSl6 SPU Reference Number: File 432 Concerning: Customer details: Mr B... Nino: ... Examination details: Employment and Support Allowance Report conducted at Highgate Medical Centre on 24/7/2009 The Scope of this Independent review As an Independent Medical Practitioner I have a duty to supply an impartial and expert opinion on the medical content of the Incapacity Benefit report which is under consideration in this Complaint investigation. The report should satisfy the quality standards laid down by Atos Healthcare, which are: - The medical content must be medically and technically correct, with enough detail within it to support any opinions or any advised assessment. - The report must be fair and impartial. - The advice must sit within a general medical consensus view. This latter point is tested by asking this question-if other doctors examined this patient is it probable that they would offer the same opinion? I have read all the documents supplied by the Customer Relations Team. This includes the ESA report which is the subject of this complaint and all the ensuing communications between Mr B... and those members of the Customer Relations Team involved with his complaint. Page 2 of 7 Mr B...'s letters of complaint cover a broad spectrum of concerns. He has asked for a good deal of action from the Independent Tier to secure a deep investigation of general standards within Atos Healthcare. I can see the foundations of this request as he has identified much which is lacking in the management of his case. But I must confirm that a good deal of what he asks for is beyond the remit of the Medical section of the Tier. I do not consider that his complaint - based as it is on distressing personal experience- can be used as a starting point for full investigation of the principles applied in examination and assessment procedures and decisions on benefit entitlement. These procedures are governed by Legislation which allows examination by either a Secretary of State Approved and Registered Doctor or Nurse. In this instance we know that Mr B... was examined by a suitably Approved Doctor and not a Nurse. There are no Scrutiny documents within this file so we do not know who made the decision to call this claimant to examination, but be this either a doctor or a nurse the action will be within the Regulations outlining such examination arrangements. I see no point in questioning Statutory Instruments and it is not within the responsibilities of the Independent Tier to do so. There is a very real difference between breaking a law and inefficiency. I am not saying that Atos Healthcare has been inefficient - that is for others in the administrative section of the Independent Tier to decide- but more importantly I cannot see any "illegal" action within the departments put before me for this particular case. I will not enter into any wider debate. There are reasons for that- and they are that very often in such debates the claimant's case can become "lost" in side issues and ultimately that claimant is not served well. In my experience all parties are best dealt with by consideration of facts alone. Debate is always healthy but it is not appropriate in the context of this case and in my experience this sort of to--and-fro dispute rarely arrives at an agreed conclusion and often only serves to trigger more anger than is good for the patient involved. My response will be mainly focussed on the ESA report of 24/7/2009 and any other medical actions around that event. I will make recommendations at the close of that review. I will finally give some reaction to a few of the broader issues raised in Mr B...'s various letters and emails, but those will sit "outside" and will not influence my assessment of the medical actions and reporting standards for his case. From the outset in this complaint Mr B... has made it clear that he has no issue with the receptionist or the doctor who undertook his assessment at Highgate centre. I can see no stage in any of his later communications where he withdraws support for their standards. In many respects this renders superfluous the attention of the Medical Independent Tier, because our duty is to evaluate the report and ensure that a fair assessment has been provided for the DWP Decision Maker. As Mr B... is satisfied with the report my comments may prove unnecessary. Page 3 of 7 This type of report can only deal with the evidence before it on the day and cannot be expected to predict the future development of any condition. Some claimants will improve, some will deteriorate and some will remain unchanged, but that is not for any assessing and reporting doctor to predict. I appreciate at page 19 of the report there is a limited form of prognosis, but that is intended as no more than a pointer towards suitable functional review periods and is not a pure medical prognosis as we all understand it when used in the management of standard clinical conditions. So, the assessing doctor is dealing with the functional restrictions which can be shown at that particular consultation. Furthermore the examining doctor is dealing with the diagnosed conditions outlined by the GP on Medical Certification - in other words the certified cause of incapacity for work. It is always possible that the doctor could find an alternative or additional diagnosis, but that is not the purpose of the report and there are specific procedures in place to allow a doctor to take action when such an event occurs. But it did not happen in this case- Dr Ludmila Semetillo accepted and worked along with the diagnosed condition. I point this out as the standard procedure because it is something that Mr B... has raised in his letters in which he suggests that the assessment is aimed at challenging established diagnoses. This is far from the case - the intention is to build up a picture of functional ability and show the practical effects of that condition, in order to allow the Decision Maker to understand what the claimant can or cannot do. In my view this has been well executed at this examination. We should thank both Mr B... (who was fatigued and distressed by the travel arrangement and the delay at the MEC) and Dr Ludmila Semetillo (who saw this case at the end of a day and when an HCP had decided the the case was too complex to be handled by a nurse) because together they both delivered enough detail to create a full report. In certain sections the report seems generous- for example I believe that descriptor MCc at page 12 is poorly supported by the evidence in the report. But I will not criticise that because Dr Ludmila Semetillo was with this claimant and often the mental and cognitive functioning is best dealt with at face to face discussion. I therefore honour the decision to apply descriptor MCc and the other description which serve to outline the disability experienced by this claimant. I would have liked to know more about the underlying cerebral tumour but it is possible that at that point in time the full diagnosis had not been made. It is sufficient to understand that the tumour causes convulsions which can only be partially controlled by high dosages of Levetiracetam and that this in its turn causes fatigue along with other neurological symptoms. Consequently Mr B... is an ill man who also has the continuing distress which is attached to such a diagnosis. Does the report cover all possibilities in this case? There is one area of concern. When there is a diagnosed tumour we have to consider the extent and stage of the illness and if there is the possibility of terminal illness. This is always an uncomfortable subject to raise with any claimant, but it is pertinent because an individual who is terminally ill has acceptance of "Limited Capability for Work Related Activity". Such an acceptance means that the individual is not required to attend a Work Focussed interview at the DWP. Does Mr B... consider himself Terminally Ill? Only he can answer that direct question BUT there is a reference to this within his letter dated 26/9/2009 and again in his email dated 18/8/2009. As we have a direct denial of this possibility in the Page 4 of 7 ESA report at Page 17 headed "Limited Capability for Work Related Activity", I am making the assumption that this question was asked at the interview and that the terminal state was not a probability. Certainly Mr B... seems to have accepted the report in its entirety so he has therefore not disputed Dr Ludmila Semetillo's instruction that the claimant was not at that time terminally ill. Mr B... is quite right when he says that those who are terminally ill are not required to attend an examination. But in order for such protection to be put in place that state of terminal illness needs to be raised before the appointments are offered or even before the ESA 50 is completed. The usual procedure is for the claimant to be asked to obtain form DS1500 which is completed either by the GP or Consultant involved with the case. This will provide details to corroborate that death can be expected within the period of the next 6 months. 0nce such information is available then action is taken to ensure that an examination is not organised and that the claimant is protected from any other procedures. I am uncertain from the letters on file or if Mr B... considers he should not have been called for the examination or if after the examination the status of "Limited Capability for Work Related Activity" should be applied to him. But in either case such protective administrative actions require the provision of a DS1500 and I gather such a form was not made available at these early stages. I also consider - as Mr B... did not object to the content of the ESA report- that he had no objections to the entry at Page 17 and therefore did not at that stage consider himself terminally ill. If he does do so now then I can only advise he asks his GP for form DS1500 and gives that to the local branch of the DWP. Such action may have already taken place but I cannot pass this point in the report without adding my advice on that subject. It makes sound sense not to call the terminally ill forwards for examination but what about those who are ill? Are some claimants simply too ill to attend and did Mr B... fall into that category? Any HCP involved with the decision to summon for examination will only have access to the ESA 50 questionnaire which was completed by Mr B... on 12/6/2009. As Mr B... was examined shortly afterwards on 24/7/2009, the decision to call for examination was made in the short intervening period and was based on an up to date ESA 50. In it we are told of an escalation of symptoms 10 days before 12/6/2009 with a necessary doubling of the medication and that the check MRI was being brought forward on an emergency basis. Whilst that is worrying never the less there is little functional restriction outlined in the form and that may be why this claimant was called for examination. Should he have been called for examination?- this is difficult to answer, but if he made contact to say how difficult it was for him to get about it is hard to see why some form of support was not put in place for him. I am in favour of an assessment taking place in all but the more ill, provided it is because such a consultation often serves to iron out the complexities of a case, provided all efforts are made to limit stress/ pain etc. But if examinations are to take place in those who are more disabled than others then these need to be arranged with empathy. Was there not a nearer examination centre or even that chance of a domiciliary visit if it was essential that the assessment took place? If the claimant is too ill to travel then we should be asking if the examination is really necessary. It is always easy to criticise a decision to call him to Highgate and perhaps more could have been done to Page 5 of 7 avoid the distress he suffered on that day of extensive travel. He had after all described his medication- related fatigue and the deterioration in his condition. My concerns about extensive travel distances centre on illness and weakness which can limit stamina and tolerance of travel. If the policy is to medically assess most claimants then I accept that reasoning, but is there something in place to support those who are less mobile or who have troubles likely to be exacabated by travel? I would hope there is, but if so then those provisions do not seem to have moved into action for Mr B.... The organisation of examinations is well outside my remit, and that is something for the other part of the Independent Tier to consider. But medically I do have the right of a comment, and in this instance Mr B... and his condition were not served well by this process. It is thanks to Dr Ludmila Semetillo's efforts that we have a suitable report which allowed for action by the Decision Maker. We also do not have any real explanation for the further call for examination at the very same MEC on 24/8/2009 and that despite all the problems Mr B... had already listed with that journey. In this instance the claimant was more disturbed by the travel than the examination! Finally - for all those questions and actions in which Mr B...: invited the Independent Tier to partake- I hope I have made it clear that such involvement is not appropriate and not in his best interests. Whilst I cannot agree with some of his opinions, nevertheless as far as his examination arrangements and the content of his report is concerned I do support him. Recommendations Dr Ludmila Semetillo should be thanked for this detailed report which was completed under difficult conditions. There should be consideration given - and discussion with a senior mentor offered - on the evidence needed to support descriptors We and MCc. Neither of these are well supported in this report although I am sure there are reasons for this. I am not disputing the acceptance of those descriptors, they may well be the best assessment for this case- but in general a greater degree of evidential support would be expected. I also note there are areas where the detail in the typical day account is conflicting. For those reasons this report does not satisfy Atos Quality standards, although I accept the intentions behind it and consider that under the circumstances this has offered the best outcome for this particular case. I consider that the scrutiny action for this file was probably correct. I am not sure what current scrutiny guidelines recommend in such a case, but it seems quite logical to assess this case at a consultation given the evidence within the ESA50. Someone had responsibility for marking this case for examination by a doctor only. That was needed and could have reduced his wait at the MEC. I do not consider that the scrutineer could have anticipated such a long journey for that examination, because session organisation is not a medical function. I also consider it Page 6 of 7 reasonable for an HCP to assume that when such an examination is requested that the arrangements made will be suitable for the case and will therefore avoid undue distress. Finally if Mr B... considers that he should be considered for the provisions offered to those who have "Limited Capability for Work Related Activity" for reasons of Terminal Illness then I can only suggest that he asks his GP to supply a completed DS1500 form. If Mr B... is not terminally ill then I can only offer my profound apologies for the rather strong emphasis I have put on that subject in this report, but I have done it because I identified mention of the subject in one of his letters and an email. I join with others in voicing my regrets that Mr B... had such a difficult journey to the Highgate MEC and I hope that a suitable apology has been offered by Atos Healthcare. The Wider Issues raised in this Complaint from Mr B... I do not consider there is any value in responding to all of these but I will give my views on two of them. Mr B... has made several references to Dr Wright and his responsibilities and has included a copy of the referral to GMC. He asks for Independent Tier to support that GMC referral. I think that this GMC referral is unfounded and I cannot support it for the following reasons: - All doctors understand that they, as individual Practitioners, are responsible for their own Professional conduct. If a doctor makes a Professional error they cannot blame it on some one else! Certainly not Dr Wright - Secondly Dr Wright is responsible for setting and conveying the agreed Professional Standards that are required within that medical service for the DWP. He is there to ensure that those standards are given to all employed HCPs. Beyond that it is up to each individual doctor and nurse to understand and accept those standards and to ensure that their personal and Professional conduct meets those standards. - As Mr B... is not complaining about Dr Ludmila Semetillo's standards I do not understand how Dr Wright has been culpable for anything. - The wording in Atos Healthcare literature is worrying and I think we can all accept that there is no more confusing word than "customer". Whether we like the word or understand it differently is a question of semantics. I will leave that to those who have responsibilities for forms, but I cannot see that as sufficient grounds to involve the GMC. - Finally, the referral is at the start entirely between Mr B... and the GMC. It is the GMC who will decide how to investigate and what action - if any- is required. The Independent Tier can have nothing to add to that process. Page 7 of 7 Mr B... also makes reference to the BMA's intention to discuss issues around the use of non-doctors in the assessment of patients for the DWP. I am surprised at that statement. The BMA would be well aware of the use of nurses in various branches of medical assessment and in delivery of treatment. The NHS abounds with Nurse led clinics where highly trained nurses assist in the delivery of NHS care. The concept that a nurse can only provide basic care went out of fashion many years ago. Nurses are now a highly trained body of Professionals who have wider skills by far than in the past. The option for an HCP assessment is written into the Legislation for Welfare Reforms and that is a fact surely known to the BMA. Debate always has a value, but in this instance the political initiative has progressed well beyond any early consultation phase. Again the Independent Tier cannot become involved and in this case the issue does not seem relevant because Mr B... was examined by a doctor of whom he has said "I have no complaints about the receptionist or the doctor I saw. They worked well in difficult circumstances" His comment mirrors my own view of the medical aspects of this complaint, and it will be for others to decide how efficiently this case has been administered.