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Claiming Benefits & Conflict Resolution GP ST3 Teaching Tameside and Glossop.

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Presentation on theme: "Claiming Benefits & Conflict Resolution GP ST3 Teaching Tameside and Glossop."— Presentation transcript:

1 Claiming Benefits & Conflict Resolution GP ST3 Teaching Tameside and Glossop

2 Aims & Objectives An overview of benefits available Who is eligible for which benefits Case scenarios to test theory out How many people complain Why do they complain What do we need to do How do we do it

3 Financial Benefits Split into several categories Can fit into more than one category at a time! Which ones are you familiar with? How much do they pay?

4 Benefits Child Housing ESA Income Support JSA DLA PIP Council tax reduction Carer’s allowance Attendance allowance Universal Credit Budgeting Loans Crisis Loans Winter fuel payment Cold weather payment Sure Start Childcare grant School meals Funeral payment Bereavement payment Bereavement allowance Guardian’s allowance War widdow pension Widowed parents allowance Working tax credit Child tax credit

5 Benefits Changes Several over last 12 months including changes to PIP and benefits caps which are being progressively rolled out Cap of £500/week for couples and single parents with children living with them Cap of £350/week for single adults

6 SSP Paid by an employer for 28 weeks provided the employee earns more than £111 before tax per week Amounts to £87.55 per week

7 Income Support Those working 16 hours or less per week aged over 16 Pays between £57.35 (young single) to £113.70 (couples where both over 18) Paid into your account every fortnight Savings and household income can affect your ability to claim

8 Child Benefit One person can claim for each child under 16 Eldest child = £20.50/week Additional children = £13.55 per child If you or your partner earn over £50,000 annually then a tax charge will apply This is 1% per £100 over £50,000 you earn pre-tax

9 Housing Benefit Can help to pay rent No set amount - £250-£400 Not for paying bills (heating, water, electricity) Depends on – whether you rent privately or from council – how many empty bedrooms you have – what your household income is – how much you’ve saved

10 Bedroom Tax If you have 1 empty bedroom you may forfeit 14% of your housing benefit For 2 empty bedrooms this goes up to 25%

11 Council Tax Reduction For those on low incomes who pay council tax Depends on where you live, your circumstances, your household income, whether your children live with you, whether other adults live with you Can be upto 100% reduction

12 Winter Fuel Payment £100-300 tax free if you were born before 5 th January 1952 Paid automatically between November – December Usually received if you’re on a state pension or another social security benefit (not child/housing benefit or council tax reduction)

13 JSA For people aged 18 – pension age Work less than 16 hours per week, income less than £6000, not in full time education Need to attend JSA interview, look for work Paid every 2 weeks into an account Under 25 = £57.35/week 25 and over = £72.40/week Couples without child = £113.70/week

14 DLA & PIP Being replaced by Personal Independence Payment, for people aged 26-64 PIP is £21.55 – 138.05 awarded according to how your illness affects you rather than the nature of the condition Illness needs to have been present for at least 3 months and expected to last at least 9 months (unless terminal condition)

15 PIP Daily living component (care component for DLA) Mobility component Extent of financial support decided by assessment process If condition is terminal PIP can start immediately with the DS1500 form completed May be eligible for vehicle tax exemption or 50% reduction

16 Carer’s Allowance £61.35/week to help you look after someone with substantial care needs No need to be a relative Aged 16 and over Working 35 hours per week caring for someone who may or may not be related Taxable and can affect other benefits

17 Attendance Allowance For those aged 65 and over To help with personal care if physically or mentally disabled £54.45 or £81.30 per week

18 ESA For those people unable to work due to illness or disability Work capability assessment will divide people into work-related activity group or support group £57.35 to £108.15 depending on age and duration of inability to work Does permit working upto 16 hours with income upto £101 per week Influenced by savings and household income

19 Universal Credit Introduced in April 2013 Will replace – JSA – ESA – Income support – Working tax credit – Child tax credit – Housing benefit

20 Universal Credit Designed to go down as your earnings go up, thus meaning you can work as much as you want Claimed online but need to attend face to face interview

21 How Is This Relevant To GPs? Important to have an understanding of patient rights to claim Important to be able to understand why patients are angry about not receiving money Tested in the AKT +/- CSA Important to consider what an employer’s perspective is

22 Scenario Patrick is a 74 year old man known to the surgery but new to you personally. He initially seems confused about why he’s come to see you, then starts weeping. He wipes away the tears, clearly embarrassed at a perceived moment of weakness. Upon further questioning he reveals his wife was diagnosed with metastatic lung carcinoma last week

23 Case Scenario Consider the benefits that Patrick or his wife might be entitled to. How can you help in providing support? What information do you need to decide which benefits they might receive?

24 Case Scenario Joe is a 34 year old self-employed builder – whilst working on a new house he fell from the roof. He spent 16 days in ITU with head injuries and 3 months in hospital before finally being well enough for discharge. His gait and balance remain poor, he struggles with concentration and his wife has noticed his personality has changed, he suffers with outbursts of anger having previously been “chilled”

25 Case Scenario What information do you need to help you decide which benefits Joe can claim? Which benefits do you think Joe might be able to claim?

26 Complaints & Conflicts

27 Complaints In Context In 2012-13: 109, 300 written complaints against NHS hospitals and community services (medics, surgeons, nurses, midwives, HVs) 52, 700 written complaints against family services (GPs, receptionists, dentists) Commonest reasons clinical, communications & attitude, administration

28 Complaints In Context 2002-032003-042004-052005-062006-072007-082008-092009-102010-112011-122012-13 All NHS written complaints133,867133,469133,820138,396133,393131,022137,736151,832149,765162,129162,019 Total HCHS Complaints91,02390,12290,41395,04790,80187,08089,139 (1) 101,07799,057 (2) 107,259109,316 Total organisations approached for data.. 394392393390381453459 of which Foundation Trusts not returning data (3).. 817231823 (2) - - Organisations providing data for year and year before.. 565297369366361338350417 Total general practice (including dental) health services Complaints42,84443,34743,40743,34942,59243,94248,59750,75550,70854,87052,703

29 Complaints In Context Main reason for complaint % Failure in, delayed, wrong diagnosis30 Attitude or rudeness of doctor14 Inadequate/inappropriate Tx/Mx11 Other10 Failure/delay to visit8 Failure to perform or inadequate exam5 Failure/delay/inappropriate referral5 Prescription problem/error4 Miscellaneous3 Removal from list3 Administration3 Failure to investigate2 Consent issues2

30 How To Deal With A Complaint Personal anecdotal experiences?

31 The Necessary Steps To Take How long do patients have to complain, does it vary between Eng / Scot / Wal / Ire Which necessary steps can you think of What are the timeframes

32 The Necessary Steps To Take Eng = 12m, all others 6m For England: – Acknowledge within 3 working days – Resolve within 6m – 2 tier system, local then ombudsman

33 Why Take Complaints Seriously? Avoids more work if things go wrong Damage to reputation Escalation – often unfounded GMC referral Litigation

34 What Do We Need To Do? Background work – Listen to the complainant – Establish their concerns and expectations – Consider a face to face meeting – Involve the complainant in scheduling – Ensure they know what is going to be discussed – Inform them of their right to bring someone

35 What Do We Need To Do? Keep a record – For governance processes – To reflect on – For evidence for others

36 What Do We Need To Do? Assess the situation – Not all complaints are written – Consider the severity of a verbal complaint – Ask for help and guidance, look to colleagues, those not involved in the situation, defence unions

37 What Do We Need To Do? Investigation – Impartial, thorough – Depth influenced by extent of potential harm to occur – Planned with a schedule agreed

38 What Do We Need To Do? Complete the cycle – Write to inform the complainant of the findings – Explain the evidence – Offer an apology if one is owed – Respond empathically even if an apology is not felt to be appropriate – Remind the complainant of their right to escalate to the ombudsman

39 Complaints & Conflicts Common Lots of information available from DOH and defence unions No one way of handling – response should be bespoke to each occasion The use of proformas is good practice for consistency

40 Case Scenario A 45 year old patient expresses their displeasure with her recent treatment – she was given amoxicillin for her chest infection but remembers having an allergic reaction to penicillin a year ago, attending A+E and requiring intravenous medication which she thinks was adrenaline

41 Case Scenario What do you need to do next? What would you like to find out? What would your outcome be?

42 Summary Benefits – What they are – Who gets what – What is changing – Why you need to know Complaints – How frequently they’re received – Why people complain, how to avoid them – How to deal with the problem

43 Any questions?


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