Tagged: psychosis

Work Programme adviser: ‘Almost every day one of my clients mentioned feeling suicidal’

A scandalous picture of suffering, trauma and destitution is painted by a former Work Programme adviser who was tasked with getting claimants off the employment and support allowance (ESA) sickness benefit.

Speaking to the press for the first time since she quit the job last year, Anna Shaw (not her real name) says:

“Some of my clients were homeless, and very many of them had had their money stopped and were literally starving and extremely stressed. Many had extreme mental health conditions, including paranoid schizophrenia, psychosis, bipolar disorder and autism.

One guy [diagnosed paranoid schizophrenic and homeless] came to see me for the first appointment and mentioned that he had not eaten for five days. I offered him my lunch, thinking he would refuse it out of pride, and he fell upon it like a wild animal. I’ve not seen a human being eat like that before.”

Shaw can only speak out anonymously, because when she resigned, after just a few months in the job, her employer made her sign a confidentiality clause.

She believed that the majority of her ESA caseload of about 100 clients were not well enough to have been on the government’s welfare-to-work Work Programme, but should instead have been signposted to charities that could support them with their multiple problems.

“Almost every day one of my clients mentioned feelings of suicide to me,” she says. Shaw says she received no training in working with people with mental health issues or physical disabilities.

Under the government’s welfare reforms, Shaw’s clients would have completed a controversial test, called the work capability assessment (WCA), currently conducted by contractor Atos, and been placed in the work-related activity group (WRAG) of ESA because they were judged capable of working, albeit with appropriate support.

Shaw’s employer was subcontracted by one of the 18 “prime providers” the government pays to implement its Work Programme to get jobless people into employment. However, Shaw says she was never given a copy of her clients’ WCA, which details their health conditions, so it was difficult to provide the support they needed.

Shaw thinks many of her ESA claimants wanted to work, but the “fundamental issues” – their physical and mental disabilities, often coupled with situations such as homelessness or domestic abuse – were not dealt with.

Every person who came in needed specialist help on a whole range of things, and to be supported, not under imminent threat of losing their benefit the whole time.”

She believes many of her clients had been wrongly assessed as fit to work. “I had a woman with multiple sclerosis who had been domestically abused and was suffering from very severe depression and anxiety, and she had a degenerative condition and she was deemed fit for work,” she says. “I gave people advice under the radar about how to appeal … but it was absolutely not in our remit to encourage people to appeal.”

The most recent government figures (to June 2014) show that only 2% of longer-term ESA claimants find sustained employment. Independent research by the Centre for Economic and Social Inclusion has found that disabled people are about half as likely to find employment as non-disabled people. Last week, a report suggested that officials were considering cutting ESA, which is paid to around 2 million people, by as much as £30 a week as the chancellor, George Osborne, seeks a £12bn cut in the welfare bill.

Shaw says she was expected to enrol claimants on back-to-work courses.

“It was very much ticking boxes. My managers were just obsessed with compliance with the Department for Work and Pensions (DWP). We would be penalised as an organisation if we didn’t sanction people who failed to show up… but with ESA they realised there was very little chance of getting these people into work. They were kind of parked.”

In the past year, sanctions for ESA claimants who fail to turn up for interviews with their job adviser have increased more than sevenfold. In each case, claimants lost at least one week of their benefit money, even if they said they were too ill to get to an appointment.

“One minute we had to sanction and the next minute we were told absolutely not to sanction,” says Shaw. “I think this was in response to [hostile coverage to sanctions in] the press… so the advice was given that we weren’t sanctioning them but we weren’t to let them know we weren’t sanctioning them… so they would come for appointments.”

According to one of Shaw’s former colleagues who is still working for the organisation, sanctioning has intensified.

“She said: ‘It’s got a lot worse since you left and now we’re having to sanction all the ESA claimants if they don’t turn up for appointments,’” says Shaw.

Two months ago, the work and pensions secretary, Iain Duncan Smith, stated that the WP “revolutionises the way we provide support to those who are the hardest to help, supporting a move from dependency to independence and getting people into work so that they have financial security for the future”.

But Shaw’s revelations contradict the ministerial architect of welfare reform. She says:

“I felt that my job was really a non-job and as long as I ticked the boxes, they didn’t really care what I did with them… but they missed the point that these were actually human beings that I was coming into contact with, and going home every night wondering if these people were still alive.”

Shaw’s claims are backed up by a recent report, Fulfilling Potential, compiled by a WP client, Catherine Hale , with support from Mind and the Centre for Welfare Reform.

Of the 500 people on ESA who responded to an online survey, 82% said their WP provider made no effort to adapt jobs on offer or make it easier for them to work. Only 7% said their adviser had a copy of their WCA.

A spokesman for the DWP says Work Programme providers “have the freedom to design any work-related activity so it is appropriate to the person’s condition”, and the DWP “offers more money to providers for helping the hardest-to-help groups into work, such as people on ESA”.

But there is no breakdown of how much of the £1.37bn WP expenditure from June 2011 to 31 March 2014 was spent on helping ESA claimants. He insists that sanctions are “used only as a last resort” and “about 99% of ESA claimants don’t get a sanction”. He adds that the DWP is looking at how to share information about clients’ medical conditions with WP advisers.

Source – The Guardian, 05 Nov 2014

Fears for mental health patients as 150 jobs go at North East health trust

Fears have been expressed for some of the region’s most vulnerable patients after it emerged more than 150 frontline NHS posts will be cut.

As many as 169 posts at Northumberland, Tyne and Wear NHS Foundation Trust will be lost under radical plans to change the way that care is delivered to mental health patients.

Nurses are set to be the worst hit, though a total of 867 employees will be affected as staff may be required to change their place of work or undergo different shift patterns.

Plans put forward for consultation will see wards close, services relocated and the development of new units as the trust aims to reduce costs by 20% over a five-year period.

Health chiefs have insisted that the changes will significantly improve patient services, but staff and unions have raised fears over employees’ safety and future staffing levels.

Glenn Turp, regional director for the Royal College of Nursing, said: “Trust management have told us that although they are endeavouring to redeploy all of the staff who are affected by the restructuring, they can not give guarantees that all staff will be redeployed, and as a consequence they have issued ‘advance notice of redundancy forms’ affecting around 170 staff.

“The fact remains that local NHS employers are in the invidious position of having to make huge cost savings that are not deliverable without having a negative impact on patient care, frontline staffing and inpatient activity.”

Thirteen new schemes will be introduced across the region covering all aspects of mental health, including older people’s services, psychiatric intensive care and male high dependency.

Community services will be enhanced so that fewer people will require hospital admission.

It is believed that more than 90 beds will be reduced and new ways of accessing treatment introduced for those with psychosis, non-psychosis, cognitive disorders and learning disability.

A mental health nurse, who has asked not to be named, said: “A number of challenging patients who used to be managed within the hospital setting are now going to have to be cared for in the community.

“Without significant additional investment in community services and staff, this will put significant pressure on both the patients themselves, and their families who will be increasingly relied upon to provide support when NHS staff are not available.

“For those patients who do not have a supportive family network, this may put both their health and safety at risk.

“The public should be concerned about the scale and the nature of this restructuring, because it looks as if community care is being delivered on the cheap. That has implications for everyone.”

The trust is currently working with staff on the proposals and a number of public consultation events have taken place. It is expected that the changes will come into force within the next two to three years.

A spokesperson for Northumberland, Tyne and Wear NHS Foundation Trust said: “Service users, carers, the voluntary sector and our commissioners and local authorities have been involved for many months in developing our plans for mental health services across Northumberland, Tyne and Wear.

“The vast majority of our services are provided in the community with only 3% of our patients ever needing to go to hospital, yet we spend more than 50% of our resources for services on our inpatient beds.

“Our aim is to improve quality in both our inpatient and community services whilst at the same time meeting the cost savings required of us.

“In terms of our inpatient beds, the trust currently has over 650 beds and as an example, in the last three weeks we have used in the order of 470 beds each day.”

Source – Newcastle Journal  23 April 2014