Appendix G:
Assessment processes

Introduction

Powys processes HB and CTB claims at its 3 shire offices. Assessment staff are responsible for dealing with all aspects of determining and paying HB and CTB claims. They have no written or operational procedures to assist them with this process and have received little formal training on the law over the past few years.

The introduction of a new computer system in November 1998 caused disruption across all the shire offices. Extensive user training on the system took place in February 1998 and this was followed up with refresher training for some staff in June and July 1998. However, Brecknockshire and Montgomeryshire, having previously used in-house systems rather than a software package system, found that the conversion had a far greater impact on their work. Montgomeryshire had not yet fully recovered from the conversion at the time of the inspection and was still having severe difficulties with its workload, with a 2 to 3 month backlog of outstanding work. This is not reflected in the sample of cases that we looked at for Montgomeryshire, as they were mainly claims determined before and during the conversion to the new computer system.

Benefits staff in all 3 shire offices have been required to provide cover for the cash offices in each of the areas. This has greatly affected the amount of time and resources available to administer HB and CTB. At Brecknockshire it was estimated that approximately 120 to 140 days a year were lost to providing cover for the cash offices over the last 4 years. However, during the course of the inspection, we established that another department will provide this cover in future, so the issue should be resolved.

We visited all 3 shire offices during the on-site phase of the inspection and looked at a number of cases in each office to determine whether procedures and regulations were being applied. It should be noted that Powys received some of the cases we sampled during the period when its previous computer systems were ‘closed down’ for conversion to First Software. We interviewed a selection of staff at all levels.

Conclusions

We found a number of good practices at each shire, including:

• an excellent relationship with the ROS, with referrals sent in accordance with current legislation
• benefit periods tailored to claimants’ circumstances, for example:
  • to the date of the last order if a claimant is in receipt of FamC
  • to the end of the tenancy if the claimant has a 6-month shorthold tenancy
• follow-up of non-returned renewals at Radnorshire by sending an:
  • NHB5 to BA if the claimant is in receipt of IS or JSA(IB)
  • earnings certificate to the employer if the claimant is employed
• checks on new claims and renewal claims for previous HB/CTB claims and overpayments
• issuing and processing renewal claims promptly.

However, we also established that:

• there were significant differences in the working practices across the 3 shires
• performance against prescribed timescales was poor in the cases we sampled. However, we are satisfied that Radnorshire has now fully recovered after the conversion to the new computer system and is processing work on the day it comes in. Brecknockshire has almost fully recovered, but Montgomeryshire has not recovered at all and currently has a 2 to 3 month backlog of outstanding work. Management at Powys has recently taken steps to deal with this matter
• verification standards on new claims are fair, but with differences across the
  3 shires
• verification standards for renewal claims can be poor, again with variations across the shires. XXXX XXXX XXX XXXXXXX XXXXXX XXXXXX XXXXX XXX XXXX XXXXXXXX XXXX XXXXXXXX XXXX XXXXX XX XXX XXXX XXXX XXXXX XX XXXX XXXXXXX XXXXX XXX XXX.

Findings

To assess how efficiently Powys processes claims for benefit, we chose a random sample of 58 live claims. Of these cases, 28 were new claims and the remaining 30 were renewals. The period covered by the sample was 7 July 1997 to 17 May 1999 and most of the cases were determined during the conversion period or within 3 months of conversion.

New claims

The Figures in this appendix compare the results of the sampling and interviewing carried out across the 3 shires. The percentages shown apply to those cases to which a particular criterion was applied rather than the total cases sampled.

Source: BFI interviews and analysis

As can be seen from Figure G.1, all 3 shires perform well in this area. Powys’s claim form asks for the claimant’s previous address so that these checks can be made. This illustrates that Powys is making good use of the information it already holds, which helps to act as a preventative measure against the potential for fraud to enter the system.

Outstanding overpayments are currently checked for manually. This is a very labour intensive task which runs the inevitable risk of information being missed. However, when the computer system’s overpayments module is fully operational, this will be done automatically and any outstanding overpayments will be automatically transferred back into the Benefits system for recovery from any new award of HB.

This analysis shows that performance against the set 14-day targets for determination were relatively poor at that time and below the reported national average.

Source: BFI analysis

Verification for new claims is fair, XXXX XXXX XXXXX XXXXX XXXXXX XX XXX XX XXXX XXXX XXX XXXXXXXX XXXXXXXXXXX XXXXXXX XXXXXXXX XXXXXXXX XXX XXXXX XXX XXX XXXXX The use of the RO and verification of non-dependant status, capital and savings was excellent, with all 3 shires achieving 100%. XXXX XXXX XXX XXXXXXX XXXXX XXXX XXXXX XXXXX XXX XX XXXX XXXXXXXXXX XXXXXXXX XXXXX XXX XXX XXXX XXX XXX XXXXXX X XXXX XX XXX.

Renewal claims

Source: BFI interviews and analysis

The analysis shows that all shires check renewal claims against previous claims and we commend them for this good practice.

Radnorshire is the only office to use a shortened renewal form for claimants in receipt of IS or JSA(IB). We cannot condone this practice, as it does not fulfil full verification requirements and creates the potential for fraud to enter the system undetected. However, Radnorshire is the only office to follow up failed renewals. If all 3 shires adopted this practice, we consider that Powys would add to its current preventative and deterrent measures by uncovering undeclared changes of circumstances. Additionally, it could prevent possible financial hardship and future requests for backdating by identifying vulnerable claimants who have failed to understand the implications of not returning their renewal claims.

Source: BFI analysis

This analysis shows that some poor verification standards exist for renewals. XX XXX XXXXXX XXXX XXXXX XXXXX XXXXX XXXX XXXXXX XXXXX XXX XXXX XX XXXX XXX XXX XX XXXXX XXXX X XXXXX XXXXX XX XXXXX XXXX XXXXXX XXXX XXXXX XX XXX XXXX XXXXX XXXXX XXXXXX XXXX.

We feel that it is important to recognise that Powys’s staff have put in a great deal of work between November 1998 and April 1999 to ensure that performance has improved. Although our sampling shows poor performance for the period during and following the conversion, the current situation is significantly different for Brecknockshire and Radnorshire. There was no evidence of backlogs at the time of the inspection and staff were dealing with claims efficiently. Additionally, management had secured additional resources for Montgomeryshire and was taking positive steps to alleviate the workload and other associated pressures on staff.

* Highlighted parts of this report are omitted from the published version as they may assist fraudsters or may contain confidential commercial information.