ESA Problem Areas

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ESA Problem Areas

ESA Safeguarding Guidance

2nd March 2016

Corin Hammersley Owen Stevens

©Greenwich Welfare Rights Service 2016 Page 1 of 18 Contents

©Greenwich Welfare Rights Service 2016 Page 2 of 18 RBG Safeguarding Factsheet

Welfare Rights Service Advisers factsheet – February 2016

DWP Benefit Safeguards Protecting vulnerable ESA claimants

Introduction claimants and to get benefit back into DWP benefit safeguards are designed to payment for destitute clients. ensure that vulnerable people are safeguarded before any decision is taken Tip: Advising a client to submit a to stop or sanction their Employment and safeguarding alert at the start of their Support Allowance. ESA claim can help to avoid problems later on. See page 4. The safeguards are a useful tool for The factsheet has sections on: advisers to ensure that clients with mental  The minimum requirements. health conditions, learning disabilities, or  Core visit safeguards. conditions affecting cognition, are  Liaising with DWP. protected from destitution.  Talking to clients about the benefit safeguards.  The weaknesses of the benefit The safeguards were introduced in 2000 safeguards. following the death of a man suffering from schizophrenia. The coroner found 1. The minimum requirements that neglect by the Benefits Agency (the After the death of the claimant in 2000 the predecessor to the DWP) had contributed DWP introduced the minimum to the death and suggested that the requirements. These requirements are Benefits Agency should have special rules designed to ensure that the DWP are not for people suffering from mental illness. neglectful in their duty of care towards Since then, safeguards for claimants have claimants with a “known background of been included in guidance for DWP staff mental illness”. The minimum and Work Programme Providers. requirements are: 1) “Where a claimant has been However, there is often a lack of awareness attending a psychiatric unit a liaison of benefit safeguards among Department officer should be appointed to maintain for Work and Pensions (DWP) and Work good relations between JCP and the Programme Provider (WPP) staff. Patient Affairs Officer.” 2) “Where it is known that a claimant has a social worker designated This factsheet aims to enable advisers to to them DWP should liaise closely with advocate on behalf of vulnerable ESA the Social Services department.”

©Greenwich Welfare Rights Service 2016 Page 3 of 18 3) “All cases, where there is a and comply with conditionality, should be known history of mental illness, should protected by the core visit safeguards. For be referred to a manager before a the remainder of this factsheet mental decision is made to withdraw benefit. The definition of a manager is Band C health conditions, learning difficulties, and or above.” conditions affecting cognition are referred These minimum requirements provide an to as ‘mental health conditions’ when overarching commitment to safeguarding being discussed in the context of core visit clients with a history of mental ill health. safeguards.

There are different core visit safeguards depending on the circumstances. Safeguards for claimants who fail to attend The minimum requirements later informed a Work Capability Assessment (WCA) or to the writing of the core visit safeguards. return an ESA50 are weaker than those which cover sanctionable failures to However, where the core visit safeguards comply with conditionality – it is important do not allow for proper safeguarding of a to be aware of the differences. client it may be that advisors can argue that the minimum requirements should DWP and JCP Sanctionable failures apply. These safeguards apply when a claimant fails to attend, participate in, or undertake: 2. Core visit safeguards  a New Joiner’s Work Focused Interview  Flexible Intervention Core visit safeguards exist in guidance  Work Programme Referral Interview covering:  Work Programme Completer Interview  Department for Work  Work Related Activity and Pensions (DWP);  Work Programme For these failures the DWP procedures are Providers (WPPs); and as follows:  Work Programme 1) If JCP have been unable to contact the Provider sub- claimant or have been in contact with a contractors. claimant but are considering not accepting good cause then a visit to The core visit safeguards build on the the claimant at home must be broad approach adopted by the minimum arranged before any sanction decision requirement safeguards. is considered. This should take place each time a decision is taken in order Claimants with mental health conditions or to safeguard claimants with fluctuating learning disabilities, or conditions affecting mental health conditions. The purpose communication/cognition (for example, of the visit is to explain the claimant’s stroke, autistic spectrum disorder, drug responsibility to comply with and alcohol addiction), or any condition conditionality and to determine that could affect their ability to understand whether they understand their ©Greenwich Welfare Rights Service 2016 Page 4 of 18 responsibilities. The visit will be carried If a claimant was mandated to do out by the DWP Visiting Service. There something by letter rather than during a must be two attempts to visit the face to face meeting then WPPs must claimant. attempt to have a face to face discussion 2) If it is not possible to visit the claimant with the client to confirm the participant or the attempted visits are has understood the activities that they unsuccessful, then the DWP says that it have mandated them to do and the has a ‘moral obligation’ to make consequences of not complying. Work organisations aware of potential programme providers should visit incidents around vulnerable claimants. vulnerable ESA claimants at home if they As such, they must attempt to contact are considering raising a compliance the following sources to establish the doubt, and are unable to see the claimant claimant’s welfare: face to face in any other way. a.Claimant’s appointee/power of attorney/next of kin The WPP should not raise a compliance b.Claimant’s community psychiatric doubt if they carried out safeguarding and nurse decided that the client did not understand c. Social services the activity and the consequences of not d.Police complying. 3) Only after these steps have been taken should the DWP consider a sanction. If they attempted to see the claimant face All cases where there is a known history to face but were unable to meet them of mental illness should be referred to a then they must raise the compliance manager before a decision is made to doubt. withdraw benefit. The definition of a manager is Band C or above. Failure to attend a WCA or return an ESA50 form In practice, failure to return an ESA50 by a claimant with mental health problems will WPP Sanctionable failures not lead to ESA disallowance. The case will WPPs and their sub-contractors are be automatically referred for a WCA if the responsible for safeguarding vulnerable DWP are aware of the mental health ESA clients. Carrying out safeguarding problems. If a claimant with mental health activity is referred to as a ‘high level must- problems has benefit disallowed due to do’ in WPP guidance. failure to return an ESA50 then notifying the DWP of the claimant’s mental health If a Work Programme Provider mandated problems should get benefit back into a client to do something during a face to payment immediately. face appointment then they do not have to carry out safeguarding activities if the Tip: Fit notes for clients with mental and client later fails to comply. physical health problems don’t always list all the conditions affecting a client. Advising a client to ensure that their fit

©Greenwich Welfare Rights Service 2016 Page 5 of 18 note lists their mental health conditions process and collect information on as well as their physical health possible good cause. The visit will be conditions can help avert problems later carried out by DWP Visiting Service. in the claim. There must be two attempts to visit the claimant. If a claimant fails to attend a WCA, the 3) All cases, where there is a known DWP procedures are as follows: history of mental illness, should be 1) If the DWP has been able to contact referred to a manager before a decision the claimant (by phone, or if the is made to withdraw benefit. The claimant has returned a form) or if the definition of a manager is Band C or claimant has previously received a above. sanctions safeguard visit for non- 4) Although it is unclear if this is part attendance at mandatory interviews of the safeguarding process the DWP then the DWP can consider procedures do allow for third parties to disallowance without a visit to the be notified of a disallowance. Wherever claimant at home. However, if when possible the decision maker should considering good cause the decision notify the claimant of a disallowance by maker considers that the claimant would phone. However, if contact cannot be benefit from a domiciliary medical they made directly with the claimant, implicit can request that the Assessment consent can allow a recognised third Provider undertakes this. party such as a social worker to be contacted. The third party must agree Tip: Note that there are fewer instances to notify the claimant of the in which DWP have to make a home disallowance decision. visit when compared to the procedures 3. Liaising with DWP for sanctionable failures (for sanctionable failures there needs to be If the benefit safeguards have not been a visit each time DWP are considering applied, contacting the Benefit Delivery not accepting Good Cause). Centre to make them aware that they should have been applied should lead to the client’s benefit being reinstated 2) If the DWP have not been able to immediately. contact the claimant and the claimant has not received a previous sanctions The Welfare Rights Service has compiled a safeguard visit for non-attendance at list of Benefit Delivery Centre contacts for mandatory interviews, then a visit to the Greenwich advisers – email claimant at home must be arranged [email protected] for a before a disallowance decision is copy and to be added to our mailing list to considered. The purpose of the visit is receive regular updates of this contact list. to explain the claimant’s responsibility to comply with conditionality and to If they do not already have it, the DWP are determine whether they understand likely to ask for evidence of the condition. their responsibilities. The Visiting Officer This could take the form of a medical will cover conditionality for the WCA ©Greenwich Welfare Rights Service 2016 Page 6 of 18 certificate from the claimant’s GP, medical The Welfare Rights Service can supply reports, and so on. As soon as the DWP you with a Benefit Safeguarding Alert are aware of a claimant’s mental health form which can be used to register a condition, they should apply benefit safeguarding alert with Jobcentre Plus safeguards, retrospectively if necessary. (JCP). The form comes with guidance to mental health professionals on Tip: Ring the Welfare Rights Service completing the form. advisers line if you need advice to help you support a client – 020 8921 6376 The form enables a professional (such (open Monday – Friday, usual office as a GP or social worker) to provide hours). their contact information so that they can be contacted as part of any 4. Talking to clients about subsequent DWP safeguarding process. benefit safeguards If the professional is subsequently While some claimants will provide contacted by JCP or one of their substantial detail about their mental health, partners, their assistance may prevent a others will be more cautious or may not significant deterioration in their patient’s recognise that they have a mental health health, and possibly destitution. condition. We have found the following questions useful when discussing benefit Return the completed safeguarding safeguards with claimants: alert to the DWP.  Is there an alternative contact that DWP could use in the future e.g. 5. The weaknesses of the benefit friend/relative? safeguards  Do they receive treatment for mental While the Benefit safeguards are an health problems? Do they take important tool, there are a number of medication? problems with the safeguards. If you  Have they received professional mental come across any of these problems when health support other than from their GP? dealing with a client then call the Welfare Are there any named professionals or Rights Service for further advice: teams that the DWP could contact?  The benefit safeguards will not be  Do they self-harm? Have they ever felt transferred into Universal Credit. suicidal?  The safeguards are not in  Have they been in hospital due to legislation. The Work and Pensions mental health problems? How long for? Select Committee report on sanctions  What are the physical effects of their after the Oakley Review recommended mental health condition? that safeguards were included in  What would the risk to mental and legislation. physical health be if the benefit is not  The safeguards do not apply to reinstated? Jobseeker’s Allowance. JSA claimants with a mental health condition will not Benefit Safeguarding Alert be protected by the safeguards.

©Greenwich Welfare Rights Service 2016 Page 7 of 18  Due to IT problems Jobcentre Plus to protect people with fluctuating referrals to the WPP include minimal mental health conditions. information about the vulnerability of  DWP guidance about the core visit clients. This can mean that where safeguarding process is unclear about JCP/DWP may treat a client as the purpose of the core visit. It seems vulnerable, the WPP may not, and vice that it can be used to collect versa. Good liaison work with the WPP information about good cause but the can overcome this for individual clients. guidance does not make this obvious. It is unclear whether this will continue to The Work and Pensions Select be a problem with Universal Credit IT. Committee report on sanctions after the  There are no appeal rights if the Oakley Review recommended that a DWP refuses to implement the review of safeguards was carried out to safeguards. In this situation an adviser clarify this point. could assist with a complaint.  Because they are not set out in  The safeguards for failures leading legislation, benefit safeguards can be to a disallowance (such as failure to interpreted in varying ways by the DWP. attend a WCA) are less comprehensive This means it is important for DWP staff than the safeguards that apply for to consider them alongside other DWP sanctionable failures. This conflicts with guidance. For example, decision the original purpose behind the makers are advised that repeated introduction of the safeguards in 2000 failures to comply with conditionality after a man starved to death after his should not make them less likely benefit had been terminated (not subsequently to accept good cause for sanctioned). the claimant’s failure to comply.  If the DWP is considering  DWP can amend the guidance sanctioning a client they have to make a without consulting or notifying visit each time they are considering not stakeholders. For example, Work accepting good cause in order to Programme Provider Guidance was protect claimants with fluctuating watered down significantly in November conditions. However, for some 2015 to allow WPPs to refer for a claimants who have missed a WCA it is sanction doubt if they have been unable sometimes possible for DWP to remove to see a claimant face to face and that benefit even if they have been unable to no safeguarding is required if a claimant contact the claimant or to establish was originally mandated during a face good cause for not attending. This to face meeting. does not mirror the DWP commitment If you would like to receive this information in an alternative format (for example in large print or Braille), please contact us on 020 8921 6376.

©Greenwich Welfare Rights Service 2016 Page 8 of 18 Please note: This factsheet will be reviewed on a regular basis. It is for advisers and not for general distribution to residents.

If you would like to use the content of this factsheet in a publication then please contact the Greenwich Welfare Rights Service to discuss this.

Welfare Rights Service Woolwich Centre 35 Wellington Street Woolwich London SE18 6HQ Telephone 020 8921 6376 Textphone 18001 020 8921 6375 www.royalgreenwich.gov.uk

©Greenwich Welfare Rights Service 2016 Page 9 of 18 Extract from ESA Guidance for Benefit Delivery Centres

02 Customer Contact: 03 Customer with Additional Needs Claimants who need help in using our services 1. This guidance aims to help staff identify and make judgements about those claimants for whom it would be more appropriate to deliver services face to face, particularly where it appears the claimant is in need of additional support. […] 3. For further guidance on dealing with claimants who need our support to use our services, see the Vulnerability Hub

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Providing Extra Support […]

20. Where the claimant has a known background of mental illness there are minimum requirements that Jobcentre Plus should be adopting to ensure that we are not found to be neglectful in our duty of care towards these claimants. The minimum requirements are:  Where the claimant has been attending a Psychiatric Unit, a liaison officer should be appointed to maintain good communications between Jobcentre Plus and the Patients Affairs Officer.  Where it is known that the claimant has a social worker designated to them we should liaise closely with Social Services Department.  All cases, where there is a known history of mental illness, should be referred to a manager before a decision is made to withdraw benefit. The definition of a manager is Band C or above.

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©Greenwich Welfare Rights Service 2016 Page 10 of 18 Extracts from ESA Guidance for Jobcentres

The following section was previously located within the following DWP guidance: 05 Jobcentre Plus Offer: 08 Failure to Attend/Failure to Participate in a Work-Focused Interview and Failure to Undertake Work-Related Activity. This guidance is now within its own guidance, called Core Visits.

Core Visits 1. If a claimant has a condition that could affect their ability to understand and comply with conditionality, a Core Visit to their home must be arranged before any sanction decision is considered. 2. A Core Visit should be considered each time a claimant FTA/FTP in a mandatory interview or fails to undertake WRA, in order to safeguard those claimants with fluctuating mental health conditions. Note: DWP Visiting will not conduct visits to a ‘care of’ address, if you are unable to trace a confident address please take action as if two ineffective visits have taken place. 3. A Core Visit is undertaken by a Visiting Officer from the DWP Visiting, to ensure the claimant fully understands why they have to attend and take part in the mandatory interview and also undertake any Work Related Activity agreed with their Adviser. The Visiting Officer does not conduct the mandatory interview. 4. If the claimant has an Appointee or someone with Power of Attorney (POA), assume that the Appointee/POA fully understands the mandatory interview requirements and is therefore being proactive in assisting the claimant to comply. Core Visits should still be undertaken in these cases and include the Appointee/POA. 5. Consider the possibility that the claimant’s Failure to Attend (FTA) might be an indication that the Appointee/POA is not fulfilling their responsibilities, in which case take the appropriate action - see the Agents, Appointees, Attorneys and Deputies Guide. 6. If a claimant has FTA an interview and not responded to the FTA letter, the Adviser reviews the case to check whether the claimant has a mental health condition or learning difficulties, or conditions affecting cognition such as stroke, autistic spectrum disorder or attention deficit disorder that might affect their understanding of mandatory interview requirements and the consequences of failing to comply. 7. If there is such evidence, a Core Visit is arranged as soon as possible, and no further action should be taken regarding the claimant’s FTA until the outcome of the Core Visit is known. The Adviser:  Refers the case to the Visiting Officer in accordance with Core Visits process, detailed in the Core Visits Guide, on form MF37 which must include:  Claimant’s condition  Claimant’s representative/third party these could include social worker, health visitor, family member/friend and so on  Details of action taken to contact the claimant or representative  If a previous visit has been undertaken  If good cause has been considered  For Failure to Undertake WRA, details of the activity the claimant was directed to undertake must be included, and the date it was to be completed by.  Request the Visiting Officer to check if the claimant is a Lone Parent with a child under one if this information is not already known  Sets a personal workflow in LMS for 10 working days to check the outcome of the visit. If this workflow matures and the MF37 has not

©Greenwich Welfare Rights Service 2016 Page 11 of 18 been received, follow up the referral following local procedures and consider extending the workflow.

Note: It is essential that the MF37 is fully completed and that telephone number included in the referring officer contact details will be manned as the Visiting Officer will need to use this to rearrange the interview during the visit. This number can also be given to the claimant for them to get in touch direct. 8. The Visiting Officer will undertake the Core Visit to establish whether the claimant understands the requirement to attend and participate in the mandatory interview and/or undertake the WRA and gather information. 9. The Visiting Officer contacts the Adviser to have the mandatory interview rebooked, or book an interview to review the WRA, by agreeing a date and time with the claimant and the Adviser. The Visiting Officer will not undertake any mandatory interview activity or make any decisions relating to deferral, good cause and so on 10. The Visiting Officer contacts the Adviser immediately if it appears deferring the mandatory interview might be appropriate, where possible this should be by telephone at the time of the visit. 11. Where the Adviser confirms the appointment has been booked, the Visiting Officer completes an appointment letter. 12. Once the visit is completed, the Visiting Officer returns the MF37 and all the information to the Adviser for good cause consideration. 13. Where the claimant is not at home or refused to cooperate see details of Ineffective Visits. For more information on Core Visits, see the Core Visits Guide.

Ineffective Visits 14. An ineffective visit is one where the claimant either:  is not at home,  refuses to cooperate, or  lives in an area that DWP Visiting deems unsafe.

First Visit Ineffective 15. In the event of an ineffective visit, the Visiting Officer will leave a letter at the claimant’s address asking the claimant to contact the Adviser within five working days. 16. If the claimant makes contact within five working days of the ineffective visit, the Adviser notifies DWP Visiting so that they do not make an unnecessary second visit. 17. If the claimant does not make contact within five working days of the ineffective visit, the Visiting Officer must attempt another visit to see the claimant face to face.

Second Visit Ineffective or where core visits cannot take place 18. DWP Visiting must attempt to undertake a Core Visit if the claimant has a mental health condition, learning disability or health condition which affects cognition but this may not be possible where the claimant lives in an area that DWP Visiting deem unsafe. 19. In these cases the HEO should continue to take the action as if 2 ineffective visits have taken place, including ensuring the safety of the claimant and that we have taken all reasonable steps to safeguard the claimant. 20. Where two Core Visits have been ineffective, the claimant’s details must be referred to the HEO to consider whether Jobcentre Plus have taken all reasonable steps in safeguarding these claimants.

Other consideration 21. It is important the HEO considers the welfare of claimants who suffer from mental health conditions, learning disabilities or health conditions which affect cognition before ©Greenwich Welfare Rights Service 2016 Page 12 of 18 imposing any sanction on benefit. Refer to the ESA Incapacity Reference Guide the if unsure whether the claimant’s condition is a mental health condition or learning disability. 22. To avoid any hardship to claimant’s in a vulnerable group every attempt must be made to ensure the claimant’s welfare. In the event of two ineffective visits, the HEO must attempt to contact the following sources to establish the claimant’s welfare:  Claimant’s Appointee/POA/next of kin,  Claimant’s Community Psychiatric Nurse,  Social Services,  Police.

Note: The contact with these people/organisations is to ensure a claimant’s welfare (we have a moral obligation to make organisations aware of potential incidents around vulnerable claimants) and not to gather information to support the Labour Market process. The Data Protection act does not allow for these people/organisations to report back to DWP the outcome of any investigations they choose to undertake. 23. Supplying a claimant’s details to Social Services or the Police in these circumstances does not contravene the Data Protection Act. Providing that there is evidence to support the referral, the sharing of information falls under the exemption category.

Next steps 24. If the HEO considers that the claimant continues not to provide good cause or it has not been possible to establish contact then they should review information (mainly from LMS) to inform the decision maker of the steps taken, including:  Considering the context of the interview and whether the interview should be deferred.  Notifying the claimant of the date, time and place of the interview and asking them to get in touch if they cannot make it.  Offering a more convenient location or a home visit where appropriate and encouraging advocacy support if needed.  Identifying any relevant issues where known that might impact on attendance.  Contacting the claimant before the interview to remind them that it is due.  Visiting those claimants with whom there has been no verbal contact prior to the interview.  Visiting every claimant with a stated mental health condition or learning disability, with their representative if appropriate, to ensure they understand their responsibilities, and details of the attempts made to visit the claimant and the reasons they are not effective. 25. Jobcentre Plus’s commitment to safeguard claimants means that all these steps should have taken place and so it is important that they are carried out and noted to inform the adviser. 26. The adviser will then gather the relevant documentation so that the case can be sent to the LM DM, including details of safeguarding steps taken. This will enable the LM DM to make an informed decision about whether a sanction is appropriate, even where a claimant is deemed vulnerable. LMS prints should not be included as the LM DM has access to LMS.

Extract from ESA Guidance for Benefit Delivery Centres

10 WCA: 08 WCA Outcomes ESA50 not returned – Mental Heath Flag Set

©Greenwich Welfare Rights Service 2016 Page 13 of 18 201. If the mental health flag has been set when the Q referral was made, the MSRS system will automatically identify any mental health cases and the cases will be referred to a Health Care Professional and the WCA referral action will continue within the Health Assessment Advisory Service.

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Failure to Attend a WCA […]

237. Where the MSRS record shows a ‘Mental Health’ flag, the DM should check if the claimant has attended or received any of the following: • Sanctions Safeguard Visits for non –attendance at mandatory interviews • telephone call BSD / Jobcentre collecting good cause information for DNA WCA • returned BF223 238. If the answer is yes to any of the above, the DM will consider ‘Good Cause’ as normal as the claimant has already had their responsibilities explained, or responded to provide ‘Good Cause’ reasons. See DMG 42261 for further details. 239. If when considering the Good cause decision the Decision Makers considers the claimant would benefit from a home visit /domiciliary visit they should request the Assessment Provider undertakes this. The DM does not have to go down the route of getting GP evidence neither does the claimant. These cases should be rare and should be treated as exceptions. DMG 42261 applies. 240. If the answer is no, and the DM is considering not accepting good cause refer the case for a pre-disallowance Safeguard visit, see Core Visits

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243. At the home visit the Local Services Officer will cover conditionality for the conditionality and WCA process. They will collect information on possible good cause and advise the claimant that they may be referred for further assessment.

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Contacting claimants who need help in using our services 157. Before an ESA disallowance is notified to the claimant you must check if the claimant may need help in using our services. See Vulnerability Hub 158. Wherever possible the DM should contact the claimant by phone to explain the disallowance decision and the claimant options. If contact cannot be made directly with the claimant, implicit consent can allow a recognised third party such as a social worker to be contacted. The third party must agree to notify the claimant of the disallowance decision.

©Greenwich Welfare Rights Service 2016 Page 14 of 18 ©Greenwich Welfare Rights Service 2016 Page 15 of 18 MF37 (Core Visit Referral form)

©Greenwich Welfare Rights Service 2016 Page 16 of 18 Benefits Safeguarding Alert

Guidance for Health Professionals The accompanying form can be used to register a safeguarding alert for someone who is claiming benefits. The alert is a statement that a health practitioner (for example GP, consultant psychiatrist, or CPN) can sign to confirm their service user’s mental health conditions, learning disabilities or conditions affecting cognition. For some benefits there are safeguarding provisions before the benefit is stopped or reduced. Unfortunately, safeguarding procedures are not always operated, and in some cases information about a claimant’s health is not fully communicated to trigger them. For benefits with safeguarding rules a completed alert should help the relevant agencies put proper safeguards in place. For benefits without safeguarding rules a completed alert could still help to ensure that reasonable adjustments are made and/or additional support provided to ensure that problems do not arise. It would be a great help if you can complete this alert. If you are subsequently contacted by JCP or one of their partners, your assistance may prevent a significant deterioration in your service user’s health, and possibly destitution. The safeguarding alert can be used with benefit claimants who have:  Mental health conditions  Learning disabilities  Conditions affecting cognition (including autism or addiction)

We hope you will find the form straightforward, but if you would like to check any details or have any queries, please contact Royal Greenwich Welfare Rights Service (details below). When complete, we recommend that you and your service user both retain copies. We recommend that your service user visit their local Jobcentre to ask for the form to be sent to the office which deals with their benefit claim, and that they request a receipt. If this is not possible, the form can be posted direct to the Jobcentre office which deals with their benefits. Produced by: Royal Greenwich Welfare Rights Service 020 8921 6375 [email protected] July 2015

Benefits Safeguarding Alert My name: Address: National Insurance Number: Mental Health Diagnoses: Learning Disabilities: Conditions affecting cognition: (e.g. autism, addiction) My signature: I am claiming benefits and wish to nominate a health professional who has personal knowledge of me, and request that you contact them as part of any future safeguarding process and to ensure that reasonable adjustments are made and/or additional support provided.

©Greenwich Welfare Rights Service 2016 Page 17 of 18 Please ensure all of the following are made aware of this alert: Benefit Delivery Centre, Local Jobcentre Plus, Relevant Work Programme Provider and their sub-contractors, Labour Market Decision Maker, and any other organisations relevant to my benefit claims. Data protection: I authorise JCP, DWP, Work Programme Providers and their sub- contractors, work capability assessment providers, Royal Greenwich, and my nominated health professional to share information by email with each other about my case. My nominated Health Professional is: Name: Address:

Email and telephone: Their status (select as applicable): GP / Consultant Psychiatrist / Registered Nurse / Social Worker / NHS Clinical Psychologist / Occupational Therapist / Employment Adviser /

Other (please state) Signed (Professional)

Date ______

©Greenwich Welfare Rights Service 2016 Page 18 of 18

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