 Fygoi'n ddifudio 13 o'r Willwyr Ffondd Cymru i yr 2015. Fygoi'n adonau'n panfru i'r eistedd. Fygoi'n ddifudio yn ddifudio nad oedd maen nhw ymlaen y byddwyr modd o fych yn ddeliadol chi'r tîmbr ti. Mae'r gydag ddifudio 1 o'r unig. Fygoi'r eistedd gan y cyffredinaf hefyd i'r ysgrifennidau diwrnod ddifendiHE, hefyd ac salas. Fygoi'n ddifu'n ddifu'n ddifudio chief executive at Atos Healthcare, Dr Barry McKillock, the clinical director at Atos Healthcare, Mark Kennedy, general manager at Salis and Kenneth Small, director of human resources at NHS Lanarkshire. I think that someone is going to make an opening statement, Mr Haley. I'll hand over to you then to open up the meeting. Thanks, Comerina. Thank you. Good morning. I'm David Haley. I'm the Atos client executive responsible for the delivery of the personal independence payment, or PIP, as I'll refer to it from this point onwards, contract. I joined Atos in March 2014 to exclusively manage the end-to-end PIP contract. I'm pleased to have been invited to today's welfare reform committee to talk about the important role that Atos plays in PIP here in Scotland. It's also good to have this opportunity to help explain how we work with our partners on PIP and also of course the role of the DWP. We have no involvement in policy setting. We are solely responsible for evidence gathering on behalf of the DWP via the assessment process so that a report is delivered back to the department for their decisions to be made. Atos uses a blended model of local supply chain partners as well as our own clinicians and we provide all of the back office support functions here in Scotland and for the rest of the UK. PIP was introduced as a brand new benefit and all parties involved in PIP have had a difficult start. Lessons and improvements needed to be worked on very quickly. People had to wait longer than we would have expected and I believe that we have been very clear that those delays were unacceptable. I'm pleased therefore to have the opportunity to provide members of the committee with an update on the progress that we have made in Scotland, which includes the increase of our headcount health professionals by four times, ensuring that the time to move through the process is now approximately four weeks, four to five weeks, where a home consultation is required. We now, with our partners, have 65 assessment rooms available across the whole of Scotland. We've also ensured that anyone who lives in an outlying area or a geographically challenging part of the country where public transport availability is difficult will receive a home consultation as part of the assessment process. I am very aware of the difficulties of the past and the concerns that surround this process, which is why I am constantly looking at ways to improve the part of the process that ATOS are responsible for. Everyone involved at ATOS in the PIP process is doing all that they can to make sure that the experienced people have of coming in for an assessment to us or one of our partners is as positive as it can be. I was therefore pleased that the committee convener and some colleagues were able to visit both the Salis and ATOS assessment centres in Glasgow and Edinburgh to see first-hand the level of professionalism and care afforded to those people visiting for an assessment. Once again, many thanks for the invitation to attend today's session. Thank you very much. Does anyone from Salis go to your comment or is that the openness statement on behalf of you all? Just briefly to share, briefly to say that despite the fact that this is the 13th meeting of the committee, this is our third visit, so we do not come on to every meeting. We are very pleased to be here, Mark and myself, in support of colleagues that we have worked very closely with in partnership with throughout the two years or so that the PIP contract has been running in Scotland. Salis' contribution to this has been to concentrate on what we believe we are good at, working with our colleagues in ATOS and DWP in terms of delivering for mainly the west of Scotland and Edinburgh city, where the 31,000 or so assessments that we have conducted we believe have met our aspirations in the initial stages when we first came to the committee and we articulated why an NHS organisation would become involved in such a matter. I would stress that Salis is fully an NHS organisation and the income that is generated from our involvement in delivering the PIP assessments is reinvested exclusively and totally within the NHS in Lanarkshire. Our quality of assessment, we believe, has justified our involvement in the public experience of the assessments that Salis has delivered, which has been a very positive one. As I said earlier, we have conducted 31,000 assessments so far. We have received 57 complaints against those 31,042 of which complaints were received after the decision in relation to benefit, and that decision is not Salis, it is not ATOS, it is DWPs, therefore I would not count them as genuine complaints against the Salis involvement, so 15 complaints in relation to 31,000 assessments is a pretty good standard. I thank Salis and ATOS for giving us the opportunity to come out and see the facilities that they operate from. Although a mock assessment is not entirely ideal, it certainly gave us a feel for what could happen in those circumstances and allowed us to speak to those who were involved in that process, which I think was helpful, even if it was not absolutely identical to the reality of going through one of those assessments. So I certainly found it very informative and helpful in doing that. But to try and get some clarity around, I am not saying that it is mythology that is built up, but certainly some of the impressions and perceptions that have been created about this process. When ATOS announced that they were entering into a partnership with Salis, I think that certainly our committee at that time and in the conversations that we had with Salis were under the impression that Salis were going to conduct the assessments across Scotland. The intention was at the outset, but the reality is that that is not the case. So we have some parts of Scotland that the assessments have been carried out by Salis, some which have been carried out directly by ATOS themselves, and I believe that there is a third partner, Premex, who are doing central and north Scotland. So we have got three different organisations carrying out PIPP, but all of them under ATOS. Yet we were told that there would be a difference in the delivery of that service because of Salis' involvement, that it would be done with a public sector ethos, which would be beneficial in the process and would be better than a private sector ethos, and yet we have both. So could you comment on how we are in a situation where we have three different delivery bodies, two of them in the private sector, one of them in the public sector? How do you maintain the standard that Salis believed that they were bringing to the table across the whole of Scotland if two of the areas that are being covered are being covered by the private sector? I will comment on the contractual arrangement that we deliver the service across two lot areas. Lot one is Scotland, north-east of England, and Lot three is south-east, south-west of England and London. We deliver that in a blended model using local supply chain partners to ensure that there is a level of familiarity there in terms of being able to provide local services locally. That was the model that we have adopted across our whole areas. In Scotland, as you say, we deliver not only ourselves direct, but also with two supply chain partners who operate through our infrastructure to make sure that we are able to deliver services exactly the same. Hopefully, having visited both of our centres, you will see that there is a lot of similarities between the surroundings, the environment and actually how the services and the assessments are delivered. I will pass to Dr McKellips to talk about the training that we use to make sure that the public sector or healthcare provision is provided in exactly the same way between supply chain partners or atos. Thank you, David. Good morning, everybody. One of the most important things from my perspective with my responsibility for the clinical performance of the health professionals delivering PIP is that we have a consistent quality service. The way that we do that is by working closely with supply chain providers to ensure that the training and support that is available to health professionals, whichever organisation they deliver services under, is exactly the same. We work closely in partnership. We provide the same training, the same level of support, the same level of on-going, continuing professional development training and engagement with all health professionals irrespective of their organisation. That, to me, is really important to understand. I think that the key phrase that you used there was, you provide the training, which indicates to me that it is atos that train the staff who are conducting the assessments, not just for atos, but salus as well. I will expand on that. The training that we provide for PIP fundamentally is based on the DWP's PIP assessment guide, which sets out to all providers the way in which PIP assessments are to be carried out and the standards that the department expects in the reports that we provide to them. The training material that we have devised for PIP is essentially to illuminate that PIP assessment guide and make it clear for providers and for health professionals how the assessments are to be carried out. That training material that we use if we are working with our colleagues in salus, we will train their own trainers and then their trainers will deliver that training to health professionals that will be working on PIP for them. We could expect that if you are trying to create a similar standard right across Scotland, we should have the same standard. Salus have told us that they have done an excess of 30,000 assessments, 57 complaints, 42 of which were against the DWP. What is that to us, those figures? We have delivered to date since the beginning of the contract. We have delivered just over 92,000 assessments across the whole of Scotland, which includes, of course, our supply chain partners as well. In terms of complaints, the registered number of complaints that we have, excuse me, just once down to that, I do have the stats. Is 276 complaints across the whole of Scotland? Okay, so quick calculation. Salus, I have had just short of 60 complaints. You have in total over 200, so 140 complaints against ATOS. Across the whole of Scotland, so pretty comparable. So the standard appears to be the same, so regardless of whether it is being conducted by the private sector or the public sector, do you believe that the standard is the same? Yeah, well, I mean, that would bear out. Okay, I will open up to other committee members. It was just for the figures. If I got this right, you are responsible for 61,000 if you take out the Salus figures, which is about twice the number that Salus have done, so you would expect about 120 complaints, but you said you are 276. To me, that would indicate that there are far more complaints from those that are conducted outwith Salus. Is that the case? So the remainder of the 60,000 is delivered between ourselves and the other supply chain partner, which is premix. We account for about 36 per cent of the face-to-face assessments that are delivered in supply chain partners that deliver 44 per cent. I think that the important thing to mention here as well is that ATOS is solely responsible for all paper-based reviews, which this time last year we were running at about 3 per cent of the total amount of assessments undertaken, and now that's currently sitting at around 22 per cent. So when you look at the complaint statistics, which are broken down and we do break them down from health professional manner and conduct, travelling and assessment centre, procedural and expenses, the majority of the complaint breakdown that we see is around the procedural side, which is people feeling back about the actual process that they've been through. So you don't think there's a significant difference in performance between the other providers than Salus, who would appear to have a very, very good information? I don't, because that number would also include paper-based reviews as well, which would tend to skew that statistic. But Salus haven't done that? Correct. None of our supply chain partners do that. I think in relation to the overall amount of assessments carried out, the numbers are tolerable in terms of a percentage, but we're always looking to continue to improve the service. I thank ATOS for coming to the committee today. It's a pity that you hadn't come before to discuss work capability assessments when that was on the go, because I think that that would have been beneficial not only for us but also for you. You've said in your opening statement, Mr Halley, that ATOS and your subcontractors have no policy responsibility for policy decisions. Do you think that the general public understands that? I think that it's important that we've had the opportunity to come here today to talk about the part that we do play in the process. It's important that we're able to talk about the bit that we are responsible for, which, as I say, isn't around the policy. It's around the delivery of the assessment. In terms of your direct question, do I think that the public knows that? I think that it's important that we have events such as these to make sure that it is understood exactly what ATOS does in the end-to-end process, which is to deliver the actual assessment. Do you think that the DWP are passing the buck for policy decisions on to guys like yourself who have taken up those contracts? I think that a number of operational assumptions were made at the time that PIP went live. We know that they haven't been borne out. It's important that the part of the process that we look after, which is the actual assessment and the scheduling and the delivery of that assessment, continues to improve. We obviously do work very closely with the department, both from a medical and process perspective, to ensure that we are always looking to improve that process. In terms of policy setting, clearly that's in the department's domain. We're always looking to continuously improve the actual assessment process itself. The former chair of the Public Accounts Commission said that the implementation of PIP had been nothing short of a fiasgo. Do you think that it's a fiasgo? I think, as I said before, that the beginning of the PIP contract for everyone involved in that was very unacceptable. However, what we've been very focused on is making sure that people who absolutely need our service and need to come through the process are seen as quickly as possible with the least amount of discomfort and as conveniently as possible. I believe that we are delivering that. In terms of research that this committee has commissioned from Sheffield Hallam University in the report, cumulative impact of welfare reform in households in Scotland, there was an estimate that 120,000 people would lose money as a result of the change from DLA to PIP in Scotland. The annual loss burden of a job was estimated to be £2,600, which obviously is a concern to many folk out there. We've heard first hand from folk at this committee about their fears of that, and yet we have seen a huge amount of backlog in terms of dealing with assessments, which adds to folk's woes and worries. How are you and your partners trying to allay the fears of folk? How are you trying to cope with those backlogs? Yes. Again, just to restate, we've been very clear in saying that it was unacceptable in terms of the backlogs. I've been very focused on, since I took over the contract with colleagues from not just Salis, but in turn as well, making sure that we deliver the assessment as quickly as possible. Increasing the amount of health professionals by four times what we had last year, increasing the amount of facilities that we have for people to be able to access for their assessment and also making sure that we can deliver home consultations out to the people that are struggling to get into our assessment centres all would have normally had too far to travel. I think that that's been all key focus to make sure that people are able to get through that process as quickly as possible. In terms of home consultations, we have the islands and lots of rural parts of the country where it's difficult for folk to get centres and recently I visited Stornoway. Some folk are put off by home assessment, folk are in their own environment, they often are better in their own environment than they are elsewhere. Do you take that into consideration when folk are being assessed at home? We look to make sure that we can deliver the assessment as comfortably as possible for every person that needs to move through this process. I think that the geographical challenges are such that it makes it very difficult for people to travel long distances. Having said that, if people are uncomfortable about being assessed in their own home, we have had situations where we've worked with some of our disability representative groups and our partnerships that we have there where we've been able to leverage some of their estate that might be available in some of these outlying areas to allow somebody to move from the home to come into a centre if that would be their preference. We always take into consideration where somebody would like to be assessed and if we can deliver it in the home and that is comfortable for the individual then that's clearly how we would deliver that assessment. We've spoken about the fear of folks, fear that they will lose money which is vital to their wellbeing as they see it. Do you think that people would gain confidence from hearing you talk about in management speak about things like a blended model and the supply chain model when it comes to dealing with these matters? I think that that's a good point. I think it's important that the public understand that going through this process can be very difficult for people so making sure that we deliver locally, the services locally and you're right it is a blended model and that may not make sense but working with partners to ensure that they have familiar assessment centres and rooms available in high streets typically where people have ease of access is important and I think that's key to what we've been delivering which is making sure that people find it as accessible as possible to get the assessment centre and delivering through partners is definitely a model that works. I don't even understand what a blended model actually is convener so I think that that would confuse people and I think you know in terms of the management speak I think it's galling enough that folk know that there is profit being made out of these assessments anyway to add the management speak into this I think just adds fuel to the fire. I understand that you have taken on these contracts for commercial reasons do you actually think it's wise for your company and others who are taking part in this who are carrying out the wishes of the DWP but having no influence whatsoever on the policies that are being made by the DWP? Do you think that it's commercially wise for your companies in the long run to take part in these assessments which obviously hold great fear for a number of folk out there? So our part in the process is to deliver the assessment I believe we deliver high quality assessments not just ourselves but with our partners in co-operation with our partners this is a contract very specific around the delivery of the assessment we only target that we work to or making sure that people get into our assessment centre as quickly as possible or have an assessment as quickly as possible and that a high quality report is then delivered back to the department for them to make their decision do I believe that's right for an organisation such as ours to be involved in that I think we take that role very seriously and I think we deliver very high quality assessments as part of that process Do you think you're being paid to be the fall guys? I think it's important that we stay on the part that we play which is as you say we aren't involved in policy we aren't involved in the wider welfare reform we are responsible for delivering the assessments and I think we've got to stay very focused on making sure that people who require that assessment are able to get there as quickly as possible and you've heard us talk about approximately four weeks to get through that part of the process and I think that needs to be as comfortable for people to go through that process as possible thank you convener it's Kevin before going on to join Joan can I just ask a follow-up question Kevin started by asking about the backlog that had been made aware of in the early phase of the introduction and you explained how you'd overcome that backlog but can you tell us why the backlog was created in the first place what went wrong that created that problem? So there were a number of operational assumptions made at the time around audit around how long the assessment was actually going to take end to end the availability of health professionals and and also staff within the department to be able to deal with with the amount of cases there's a lot of evidence to prove that those operational assumptions weren't borne out as a consequence we ended up with a situation which would became aware of very early in the process where a number of people were starting to to wait too long so our immediate response to that was to start to ensure that we grew the amount of people that we needed to undertake the assessments and create as much assessment as many assessment rooms as possible to to to meet with the demand so I think I think the reason for the backlogs were the operational assumptions that were made and I think everybody involved in that part of the process you know how it was unacceptable but I think we very quickly focused on trying to clear the backlog and get on top of the work which which we started to do by by just increasing the amount of people we had to deliver the assessments. Okay, I'll come to Joan to be followed by Margaret. Thank you very much and this committee's taken a lot of evidence from people who have been declared fit for work who were not fit for work and that evidence is echoed in the media and through disability groups it seems to be a recurring pattern for example David Waite of Del Rye was declared fit for work even though he couldn't hold a pen after having a major stroke and then there was the dreadful case of Jacqueline Harris the retired nurse from Gloucester who killed herself after a two-minute assessment said that she was fit for work and her family were very clear that it was because of that decision that sadly she killed herself. You must feel that there's something wrong with the criterion by which she assessed people when these cases keep coming up. These cases are always very difficult for us to hear about clearly in PIP the assessment for PIP is not to do with fitness for work or otherwise but it's to recognise the additional costs that people have when living with a disability. Our key role in this process is to allow the individual who comes to see as foreign assessment the time to explain the difficulties that they have day to day in their everyday lives because of the medical problems that they have and ensure that we send a report into DWP that contains the level of detail that they require to paint a picture of that person, the difficulties that they have and how their difficulties vary from day to day or from week to week so that's our part of the process in PIP. However I hear what you're saying but in terms of PIP itself for example a number of people are very distressed that their medical condition doesn't seem to be taken into account. The medical assessments that they have doesn't seem to be taken into account by the assessors. PIP assessors are there to ensure that rather than looking at someone's diagnosis, the medical condition or the treatment that they're receiving they focus on the effects of these medical conditions on people's everyday lives and what they're able to do and what they're not able to do. So it's certainly not our role as PIP assessors to question anybody's diagnosis or to you know in any way try and and ignore someone's medical condition that's not our role it's not up for question. Our role is simply to look at how that individual is affected because many people who may have the same medical condition on paper their day to day story will be very different because we recognise people are are individuals in that respect so our PIP practitioners are trained to make that assessment and to look at all the conditions that an individual has together and write a report on their day to day function. But then when I reflect the question that my colleague Kevin Stewart asked about people being assessed at home in all assessments often people have self-respect and pride and they're trying to do their best. You know when they go for an interview often they have to make huge efforts to get to the assessment process and that actually could then count against them in terms of the assessment because it's not a normal day for them they can actually make themselves ill having to drag themselves to the assessment and make the effort. For PIP I don't believe that's the case. The PIP assessment is not a snapshot and I think to your point earlier that is one of the areas that people do get concerned about and we hear people concerned in that respect. It's not a snapshot of how an individual is on one particular day, on the day of the assessment or on any other day. When we are constructing our reports for DWP we need to be very clear that we don't just look at how someone is on a particularly good day or even on the day of the assessment itself but we have to look at what we call variability so people whose condition is not the same day to day they might be able to do something on one particular day but can they carry out that task most of the time? Can they do it reliably? Can they do it safely? Can they do it to an acceptable standard? The other key as you've said to your point about someone making an effort for the assessment is that we have to be very careful to ensure that people are not underplaying the effects of their condition on their day-to-day lives and that's probably a part of our role that people don't recognise as much as perhaps they might. We need to ensure that we write a report that doesn't disadvantage people who have a very positive attitude to their condition but what we actually do is we look at what needs they have in relation to the criteria in the assessment. I'm struggling to understand how you do that. Myself and other members of the committee have had the same experience of sitting in on Citizens Advice service employees helping, advisors helping people to fill out forms and certainly my experience in the interview that I attended was that the lady continually underplayed her condition and it was only the expertise of the advisor that meant that the form he asked the additional questions of this 35-page form so that it adequately reflected the severity of her condition. That's before she even gets to the assessment so clearly there are some serious concerns here that how are you addressing them? That I think is one of the key aspects of the face-to-face assessment itself that our health professionals are able to have a conversation with the individual that comes for assessment and rather than just asking a series of questions you know how do you carry out this particular task? How do you cope with this? In every area we look at variability, we ask every individual does your condition vary from day to day? Do you have good days? Do you have bad days? And tell me about what's different between these days and that is drawn throughout the assessment so having that face-to-face conversation is very helpful in that? Finally convener to go back to my original point about the cases that the dreadful cases of people suffering because their applications have been rejected you're suggesting that things are better with PIP but under PIP we're going to see we all know we're going to see a 20% reduction in disability benefits so how can it be better as you suggest when you're actually working to actually reduce these benefits by 20%? I just want to make it very clear that we as assessment providers do not have any targets relating to any outcome of an individual case or of cases as a whole. We don't even know the outcome of any individual case that we assess. We send the report back to DWP and don't receive feedback on the outcome or the decision that's made on that. Our role is to ensure that we provide a fair assessment which has got all the information in it that the decision maker will need to come to their decision on that individual case. Would you suggest that the DWP might be coming to decisions that don't actually affect the advice that you're giving them I couldn't possibly comment because that's not part of our role. Thank you and really discontinuing along the lines that Joan has been started on actual assessments. What sort of feedback do you get from DWP? You don't know the outcome of particular assessments. What feedback and information do you get from DWP? How do you ensure that you are actually asking the right questions and that your assessors are teasing out all the information that they need to? What feedback do you get? We submit our report to DWP and at that point where the decision maker in the department reads the report if there are aspects of the case because they are when I'm explaining to individuals where the clinical team who understand about medical conditions and write a report based on that but the people in DWP are the people who know about the benefit legislation and the criteria and so on that's the area of expertise. If a decision maker looks at an individual report and wants to clarify something or isn't quite sure how a particular piece of medical information should be interpreted, they can telephone us, they can call one of our health professionals and have a discussion about that, they can send a report back with some questions for us to review and we're happy to look at that case and give any additional information that they require on it. Are the people in DWP not medical professionals? My understanding is that decision makers are non-clinical individuals, they have a background and a training in the benefit and the legislation itself. It's our health professionals who have the medical training and can write a report in plain English to explain the effects of an individual's medical condition on their daily life. We've heard from witnesses that they felt that the assessor didn't seem to be aware of what they've written in this 35 page forum because of the questions that they were asking and also some of them had provided consultant reports, there was absolutely no mention of that at their assessment. So where is that taking into account? As you say, there is a questionnaire that the individual can fill out as part of the application process. Very often people do send in further evidence like consultant's letters or information from other people who know their own situation. Our health professionals will always, as part of their review of a case, always look at that information and consider it when they're writing the report at the end. So they do take that into account. What happens, for example, we've heard evidence that if someone turns up late, because quite often they've had to travel quite a distance and when questions were asked around that, someone from Fife having to go to Edinburgh or Edinburgh having to go to Dundee or that kind of thing, which didn't seem practical to any of us. So what happens if someone is late for their appointment? We've heard that, they're told then, well sorry, you've missed your appointment and that's it. What happens? So the travel distance was a challenge last year. Obviously building extra assessment rooms and making that more widely available with extra health professionals has certainly helped. We don't expect people to travel on due distances. In terms of if somebody's late for their appointment, I'm not aware that we've turned anybody away from an appointment because they're late. Our assessors and our receptionist staff who are highly trained, our expert in being able to deal with people who attend for their assessments and distress or concern about lateness or indeed the opposite, being very early for an assessment, is always taken and managed locally at every centre and we always ensure that that's the case. So I'm not aware of any cases turned away because they've been late. If you're aware of anyone where that has happened, I'd be happy to look into that. We did hear one case, we read of it, it was in evidence that a lady couldn't get parked, for example, and she had to go round and round looking for some place to park and then as a result of that she was late for her appointment. A lot of our assessment centres are based typically in high streets and locations that are easy to get to via public transport. We've become increasingly aware, we conduct some assessment surveys at the time, the satisfaction surveys at the time where we tried to capture how people did actually get to the assessment centre, what their travel time was like, what mode of transport they used and we've become increasingly aware of the vast majority of people who tend to use their own transport or get dropped off. Delivering assessment rooms in a city centre or a town, a high street, is always difficult for parking. So when we send the appointment out we always send maps about local parking or relationships we may have with local facilities where people can park. We always try to make sure that there is drop off, certainly drop off facilities outside of our assessment centres to make sure that that's as easy as possible and we'll continue to work on our estate to make sure that where possible we're always able to provide parking facilities given that we now know that considerably more people use their own transport than public transport to get to our facilities. So we'll always try to help where we can and we always make it clear on the maps where the local parking is or the nearest parking would be. On the actual assessment, one person we had given evidence felt that the PIP was more geared towards mental health issues rather than physical. Most people who come to see us have several medical conditions and very often that's a combination of physical problems, mental health conditions, conditions affecting people's sensory function, all that is part of the assessment and taken into account. Again it recognises that everyone is an individual and that when you take every individual who has a combination of medical conditions and then how that affects their day-to-day situation it really is about letting that individual tell their own story. In terms of the assessment criteria physical and mental health aspects are taken into account in all the areas and it's something that we're very careful to look at every angle of the case in that respect. I think one of the questions is can you walk 20 feet or yards? Do you think that's a practical assessment because very often you've got to walk that to get to the actual assessment? Okay in terms of the actual criteria themselves PIP has a set of what they call descriptors within the activity which talks about someone's ability to walk and 20 meters is one of the distances that is measured in a range of anything from 200 meters or more down to people who can only walk one meter. So there is a range of different distances that are assessed. Clearly we don't set the policy and that assessment is provided to us but certainly someone who is limited as you've said to a distance of 20 meters does have a very significant problem with their ability to walk and certainly PIP would recognise that. So what happens when for example we've seen a high profile one recently very young girl who was a Paralympian she lost her PIP and because they said she could walk I mean she could I think she could manage to walk 20 meters but it was with great difficulty. What recourse do you have then because you're saying that your assessors just ask the questions to try and you know highlight and how a person's life is affected by their disability or health problems and you then see this in the press, see it on the TV. What recourse do you have then of saying well we assess that person I would have thought she would have passed you know she would have required that assistance and the financial aid that she's applied for. Do you have any discussion with DWP around that or is it just purely down to DWP to make that decision then that's it? One of the key aspects of any of the PIP criteria but since we're talking about mobility in particular is as we were mentioning reliability so someone that is able to walk 20 meters on perhaps one occasion or occasionally but can't do that reliably, can't do it safely, can't do it in a reasonable time that has to be taken into account. We have to look at the situation of how somebody is most of the time so my understanding is that even an individual who can walk perhaps more than 20 meters on some occasions if they can't do that on a reliable safe basis taking all factors of variability into account then you know that will be reflected in our report as well. Right so you would take that and are there any checks done on this you know does your service check so many of your appraisals do sport checks on just what they are before they go? So our health professionals come to us with at least two years of previous experience in clinical roles many however have much more than that they're trained in disability assessment medicine which is the role that we carry out once they have gone through an approval process to demonstrate that they're able to perform assessments to a high standard we'll continue to monitor them support them we will check reports on a random basis to make sure that the required standards are maintained and there's also a continuing professional development programme for all of our health professionals as well as a support service available mental function champions and an advice line if anyone needs to discuss a particular case or receive any further support on the practice. So if there is someone who has a disability or a condition they're not going to get any better and they would have had a lifetime award with DLA are they treated any differently do they get you know a different assessment is that taken into account because obviously their condition is not going to get any better so you know are they going to be called back in five years time i think that's what the policy is why is that happening okay so our assessors absolutely recognise that people have got just some people have chronic medical conditions which are going to stay the same or perhaps progress over over time and the advice that we give it's the same assessment that people go through and that can either be a paper based review where we look at the information that's been provided to us as we mentioned the claim form that the individuals completed and any other information that they've sent along with their claim and if there's enough information to be able to give advice without seeing an individual face to face we will do that if there isn't enough information there or we feel that we get a better picture of the individual by doing a face to face assessment then that will be carried out at the end of the assessment our health professional offers an opinion on how that person's condition might change over time and that can vary from people who have got a condition that we would expect to change in a very short period of time to people who we would advise their conditions going to stay the same in the longer period that advice is given to DWP and then they will make a decision on the length of award and any review period after that okay thank you very much your evidence that you provided to the committee was very helpful and thank you very much for it suggests that the average waiting time is four weeks i'm sorry to say i don't have anybody coming through my door who's only waited four weeks and certainly when they come to me they've generally waited much longer than that and our recent citizens advice scotland report their advisors were saying the average was six months with some people waiting 13 14 15 months and we've heard evidence at this committee on that can you can you give me some idea of how many cases are actually delayed i know that you've said you made progress on that but i mean for the life of me i have not met anyone who has only waited four weeks for an assessment decision and you know an assessment and a decision so i mean i'm baffled as to how you can you can make that claim so please enlighten us well obviously i'm disappointed to hear that that you're meeting people who are having to wait an excessive time i mean what i would say is that the statistics that we have that we measure on a daily basis confirm the statistics that that the going through the actual process taken approximately four weeks or four to five weeks of a home consultation is required i'm aware that there have been previous statistics run where we were having difficulties last year and backlogs were being worked through and indeed the DWP statistics were actually issued last Wednesday morning which was the latest set of statistics up until the end of the end of march which actually does bear with our statistics which shows nationally it's between five and six weeks to go through the process in terms of individuals that are that are coming to see you where they've waited extensive periods i mean obviously i can't comment on individual cases but i'd be happy to look into anyone who feels that they've been waiting excessively because we have to manage the caseload with our partners to make sure that we're getting those people through that process as quickly as possible and as i say that that is in Scotland that is definitely between four and four to five weeks where a home consultation is required the third force news just a few weeks ago published a report that suggested that 3200 people were waiting more than a year in scotland and that was only a few weeks ago it's April that stated i'm not aware of the report i'd have to review the report okay can i ask you one of the other statistics to statistics we have on your evidence to us is that you've delivered 92 901 assessments for people living in scotland can you tell me how many of those assessments were overturned on appeal no i'm not i'm not aware of that information so and work capability assessments last year it was 43 were overturned on appeal do you think that would be a similar figure you must know who comes back for reassessment or who comes back in appeal when not aware of the the once the decision has once the assessment report has been completed and passed to the department for the decision makers to make the decision beyond that process we we have no involvement in that process the statistical information that comes out is pointing to to the statistics that you're obviously referring to but we're not aware of of who gets overturned and at appeal so no one comes back to you for reassessment of the appeal in terms of the appeals process that's cat that would be carried out by the appeals tribunal service themselves it's not something that our health professionals are involved in okay okay the some of my colleagues picked up some some issues about full disclosure and information that people need assessments and scoresheets so they sent to people who have been through the assessment as a matter of course if an individual wants to see their assessment report then yeah they can request that from from dwp told that i'm not aware of what my experience is they're not they're not told that can you tell me if you do know how many errors turn up in scoresheets when people actually do get their hands on them and realise that there's a number of errors in them i'm not aware of that statistic okay are you aware that there's errors in scoresheets that that mark people down and then when they're challenged they're then marked up and the decision's overturned i would just say that scoresheets uh that's not part of our process we don't have such things as scoresheets within our our part of the process we write a report and and and send that back to dwp well whatever you whatever you call it other people call it scoresheets some people call it assessment forms okay you call it a report are you aware of if a number of errors that people have highlighted within those reports so if there is an error in or if there's an area within a report that someone has disagreed with or that they feel is is not correct then certainly a decision maker can send that information back to us to review they can telephone us they can send the report back for us to review at that situation how quickly do you return that information to people once i've asked for it then so if somebody if if a decision maker sends a report and wants some further information on it we return that within two days within two days and how long have they got to appeal i'm not aware of the the appeals process okay okay okay and i'm going to take advantage of the fact that you're a doctor doctor mcillip and ask if you would you would agree that motor neuron disease is a terminal illness motor neuron disease is a clearly a serious progressive condition and people don't get better people people die better as a result and they die very quickly usually 14 months as a diagnosis isn't it in most situations i mean yes so do you think that it is fair for anyone suffering from a life limiting illness like motor neuron disease to be continually assessed because of the six month period that they have to be dying within the six month before they will be considered unfit for work or considered for pip in terms of pip it's very important whether it's the situation you've just just described or anyone else who's claiming the benefit that we look at that individual's situation clearly someone's diagnosis is a very serious condition uh like motor neuron disease clearly that's a very important piece of information for us and our health professionals would take that into account we also have to look at that individual's situation at the time they make the claim and make sure that the information is passed on within a report to DWP so yes we would absolutely recognise the need to look at the diagnosis to look at what situation the individual is in at the time and write a report that reflected that right that's the point i want to get to the report that reflected that would you say to the DWP this person has a life limiting illness they will not get better and they will only progressively get worse therefore they should not be reassessed they should be given the full entitlement we wouldn't write a report that would mention entitlement we would give clinical advice on that particular situation and that would normally be based on the information that the individual is given as in their claim and the information that we were able to get from perhaps their GP or someone else who knows their condition well who's involved in their treatment and their care and our role is to pass that information on to the department in the form so that the person making the decision on the claim on the outcome of the claim and on any review period was aware of the of the circumstances of that individual case that's our job so you wouldn't give that assessment that this person should not be in the very short timescale they've maybe got left to spend with their family they shouldn't spend that fight in a system just to get the additional money they need to need to just live every day as it comes our role is to make sure that it's someone who's in a very serious situation like that who has a condition that is probably going to progress rapidly over time that our report reflected that so that a non-medical person could understand the difficult situation that individual was in but in terms of the award that's made and any decision that's made about how long that award should be for and when any review should take place that is out of our hands are you aware that motors neuron disease scotland has got a litany and a campaign running against some of the the worst ravages of the system especially work capability tests and PIP assessments are you aware of the the case studies that they have produced and the challenges that people with such a condition have faced so we work very closely with a whole range of disability representative groups both locally and nationally and that's been a very worthwhile and ongoing engagement that we have with these groups and whether it's more general situations or down to individual cases where people have a difficulty we use all the information that we get from these discussions to try and make our service fit the needs of the people who are using it so would you agree with Lord Freud when I wrote to him last year and asked him about the bedroom tax and other assessments when he said that people were going to neuron disease should maybe get a part time job or take in a lodger do you agree with that outcome I couldn't possibly comment thanks very much three areas convener I just want to explore if I may we know the form the assessment application form is challenging for many individuals it's a large physical document and I just wondered is that template permanent or are you able to feed in from your experience with your meetings with applicants as to whether improvements could be made to the form I mean is there any proposal to revise the form so the form that you're talking about which we call the pit part to the question here as with all the forms that we use it is DWP's form and we have worked with DWP on the forms that we use in terms of our assessments is what we call the PA4 or the actual pit assessment form itself and we've worked with them in order to make sure that the forms fit as well as they can with the way our health professionals conduct the assessments and some of the improvements that we've made along with DWP to that have helped considerably in terms of our health professionals and the way they carry out assessments the actual questionnaire itself we don't have any input into how that questionnaire is is designed and the other interesting area to me is having heard experiences as some of my colleagues in the committee have indicated from people living in remote parts of Scotland are your efforts to try and improve the ease of communication with them and improve the facility for the face-to-face meeting many in this digital age you say for example that you're trialling the use of video technology but I mean there already are digital exchanges whereby people can have face-to-face meetings I mean it's gonna be done on social media whatever I mean are these not initiatives which could be used now to try and assist people in this face-to-face element without having to travel extensive mileage where many of them are finding that challenging in any event because of their condition yes so so we've run a very successful trial in terms of in terms of understanding the behaviours of not just the health professional being able to conduct the assessment but actually the people coming in to be assessed and of course what we're finding because it's a functional assessment that that's some of those cases in fact quite a lot of those cases it's difficult to conduct an assessment over video but as you say certainly whether there is a face-to-face requirement or a conversation that could take place that would form the basis of the assessment then there's no reason as to why that video wouldn't be able to work and indeed the trial has been a been a great success so we're just looking at the the numbers of people that would that would be able to make use of that facility but in terms of being able to reach people in it in outlying areas then clearly it's one of the areas that we're looking at and is there a time scale for this so the trial has been underway and and we've got the feedback and we've given that back to the department we've been able to crunch the statistics and be able to provide that report back and it literally comes down to the availability of broadband availability in the home of devices etc so that's the next phase that we're looking at in terms of can we leverage things on iPads or the service through you know home use computers etc so that's the next part of the the next part of the trial but when you say that's the next part I mean as this does this require proactive engagement by you vis-a-vis the claimant or do DWP have to improve their information provision to claimants if they go to the DWP office who's giving the claimant the information that this improved communication facility may be available well in terms of it's a proactive trial that ourselves and some of our partners have been have been working on to see to see what the capabilities are and what the flexibility would be in terms of being able to deliver that assessment out in terms of the decision as to whether that will be part of the policy and part of the requirement for how we deliver PIP assessments obviously we discuss that with the department when we give the findings of the full trial but in terms of timescales I mean the trial is ongoing the next the next phase we're looking at is the availability of as I say being able to leverage over iPads or but it comes down to broadband connectivity and security of the networks obviously being able to to deliver this digitally it has to be very secure okay but I mean even if we look at the sort of pre-assessment support that some people at the moment have the IT may have access to broadband, Wi-Fi whatever it is I mean could they use that as a communication medium just now? We'd have to understand that I'm happy to go in and see where the report is in terms of the trial to and feed that back to you outside of this because there's a we have to go through the stages first about the technology first about the security and then do a limited trial in assessment centres as I say the next trial is to then look at home use and the ability to be able to deliver that out if that is ready and that's been proven within the trial which I'll which I can get an update on and I would see no reason as to why that wouldn't be made available in terms of communications my guess would be once that has been proven as a viable form of delivering the assessment then then I would imagine that that would be made public through websites and and also working you know as Dr McKillips mentioned we work very closely with the disability representative groups citizens advice have been very supportive in terms of helping deliver out in outreach areas so we'd obviously looked to be working with partners to make sure that communications are understood and people are aware when the time is right to do that. Thanks Mr Herrey I think convener the committee would find it helpful if it could be given an update on how this trial is getting on and how you're proposed to roll out from that depending on what the trial tells you the final area convener I'm interested in and my colleague Christina McKelvie was questioning we have heard evidence from witnesses who suffering from degenerative diseases will not improve will not get better very anxious about the prospect of reassessments in whatever period of time that may be and I'm just interested at Dr McKillip and perhaps this is a question for you I mean if the health professional in assessing an individual in that situation is very clear that the individual has very restricted and physical ability and mobility would find it very challenging to be doing anything whether at work or at home and the report reflects all that. I mean I'm simply wondering from your perspective in a situation like that it's presumably not good use of your time to have to reassess that person in you know two years time because they will not have got better. I mean one witness put it very eloquently and said unless I can be given a new skeleton I am going to be worse from the time of my assessment at any future period and I just can't quite reconcile the common sense of this I mean it seems to me that if your health professional having met this individual having made the assessment and DWP being satisfied and indeed giving a payment or indeed the higher payment I mean there's a no mechanism to in situations like that avoid the inconvenience and stress of a of a further review so in the situation you've described we would always give the advice in such a case that that individual's condition was likely to stay the same or perhaps progress over over time and that would be the advice of our health professional in that situation if we were referred that case back again at some future point for review my hope would be that that case with the information would mean that we would be able to do a what call a paper based review and not have to see that individual again face to face because our health professionals understand the conditions that the individual has they understand that things are likely to have stayed the same or perhaps got worse since the last assessment and be able to give advice without having to see that individual at a face-to-face assessment a second time okay thank you very much okay clear not market one is this a supplementary I'm just thinking you're talking about health professionals are they you know do they specialise in any particular a condition you know if someone has a mental health condition you know is there a particular assessor or you know half dozen assessors who would be best placed to assess that person or are they purely generic okay so all of our health professionals come to us with a at least two years clinical experience and many have much more than that and we have practitioners who have worked as community psychiatric nurses who are registered learning disability nurses we have general nurses we have occupational therapists physiotherapists paramedics working for us and in their clinical experience before coming to work on PIP they have met the a wide range of clinical conditions all those fields so when they come to PIP we recognise that a lot of the people who come to see is have got several conditions not just a physical condition or a mental health condition but a combination of several conditions and all of our assessors are trained to assess somebody's function and how their day-to-day life is affected by all of the conditions together to your point about people who specialise we have a specialist team of what we call mental function champions now they are health professionals who have a background and who are experts in a mental health or learning disability field and they've got at least two years worth of experience in that specialist field and they are always available for support to any health professional who's carrying out an assessment before, during or after so that they can offer advice and they also work with our health professionals on developing and delivering training so that we have that have the benefit of their experience passed on to the rest of our health professionals but our challenge is people who come to us with a variety of medical conditions and ensuring that we don't just focus in one area but we look at the whole individual thank you for coming on today and also for the opportunity to visit the centre which was very helpful we did take earlier evidence in relation to work capability assessments from people with mental health issues who had felt that the whole process had damaged their mental health in the mock assessment that we saw in the centre in Glasgow the actor who was presenting with mental health problems was asked about how low they had been if they considered committing suicide and it seems to me that somebody is suffering from post traumatic stress disorder perhaps from sexual abuse or an experience like that or someone who's under cognitive behaviour therapy that that whole process could be damaging to their mental health do you have a mechanism for coping with that? We try and make what we recognise can be a difficult experience for people as easy as we possibly can and that clearly includes people who have got mental health problems it's really important that our assessors recognise the impact that mental health can have on an individual's life and that they're sensitive towards that and by focusing you know not so much on the diagnosis and you know what someone's past history is in terms of their background or their mental health condition but by focusing on the hearing now and the difficulties that someone has day to day that is our role and we try and make the assessment as up to date and reflective of their current situation as possible rather than going into the details of their background. Margaret was touching on an area of concern that I had in terms of the range of health professionals that you have there because I think earlier Dr McElw if I've picked that up wrong but that you do actually give an opinion of how a person's medical condition is likely to progress to the DWP in relation specifically to MND in those areas but it's very possible that someone who presents with a motor neuron disease with MS something more rare like complex regional pain syndrome could be faced with a mental health professional who has actually had no clinical experience of dealing with those situations. We make sure that all of our health professionals have access to the information that we need as in clinical practice everyone who's working in a clinical setting will have the range of specialist knowledge but also a general background training but not every health professional can have personal knowledge of every condition at all times so we ensure that people have access to support lines that they've access to training to guidance to handbooks in order to answer the questions that they feel that they need to answer for a particular case and we would always encourage a health professional to phone for support or for guidance or to review the handbooks in individual situations like that. I appreciate what you're saying but a health professional in any other role within the NHS wouldn't be asked to comment on something that they're not professionally trained or had experience of or were working in that area to do it so somebody wouldn't go to a mental health nurse in a hospital to ask an opinion of something to do with motor neuron disease and when you come to points like people that are physiotherapists I mean they actually would have no medical training in terms of some of the things that we'd be presenting at these situations so does that not leave a huge onus on the health professional to educate themselves and make that decision as to whether they're clinically at that point competent or feel confident in making that decision of opinion on someone? The key is that all of our health professionals are registered health professionals with their individual licensing body and it is therefore their own responsibility to make sure that they work within what they feel are the guidance and the regulation of that particular professional body. They have a duty to make sure that the advice that they are giving is reasonable and that they're working to a level of competency they're comfortable with. The training that we provide for our health professionals is very much focusing on their role. They're not diagnosing, they're not treating individuals with any of these conditions that we're discussing. They're offering a report which looks at someone's day to day function so it's not the same as getting involved in the clinical treatment or diagnosis of an individual is looking at function when we're talking about review periods at the end and the section where an individual health professional gives that advice on the review of a case. We're not looking at the clinical condition so much as how the person's function is likely to change over time. They are giving an opinion of progression of the disease to the DWP, that can happen. They tell the DWP within the report when they feel that individual's function may change which either may be a worsening or perhaps their condition may improve with treatment or with upcoming surgery and that's based on both what the individuals told them about their medical condition at that time and the health professionals' own knowledge of the condition. Someone feels to look up the guides that you provide and has failed to investigate and makes an error of judgement in that process. How is that ethical if it's left to the individual and there's no check-up on whether the assessment that's given is actually valid by someone who is clinically and medical qualified to make that opinion? One of the things we talked about earlier was working very closely with the disability representative groups because we are aware that there's many different conditions that present themselves during an assessment. One of the things that we found works really well is what we call a conditional insight report, which is where we work with the various bodies within the representative groups to help us capture and understand particular conditions that may be more rare in terms of that could be assessed. That is part of the delivery that we deliver out to the health professionals to make sure that they have an understanding and a training capability. Indeed, there's regular sessions where we deliver continual professional development, which is on a quarterly basis with the health professionals. There's just been refresher training on the latest modules that would capture some of the conditional insight reports that go in there. There's a continual loop around making sure that health professionals are aware of all of the conditions without them being expert in particular conditions but understanding particularly from the disability representative group's perspective how best to be able to handle that individual that may come with that particular condition. Final question is, obviously, we're going through the evolution of further powers to Scotland and PIP is due to come into the competency of the Scottish Parliament. I know that the Scottish Government has made representation that this should have been delayed at this stage, and certainly the devolution should have happened before the 20 per cent cut that is coming from the UK Government. Do you have any opinion as to whether it would have been sensible, given that the Scottish Government may change PIP that this should have been delayed until after the devolve power? Again, I think it's important that we reflect on the reason that we're here today and have been invited, which is to talk about the part of the process that we're responsible for, which is the delivery of the assessment. Our contract is with the Department for Works and Pensions. That continues until the contract ends. We remain focused on that to make sure that people who require the assessment get seen as quickly as possible. Of course, we'd be delighted to have conversation with the Scottish Government about where welfare may go, but our focus is absolutely on making sure that we deliver the assessments as part of the end-to-end process in contract, along with partners, into the DWP. Christina and then Kevin for supplementary. It's a really quick supplementary. My colleague Claire Adamson had asked about if there was a serious misjudgment and a failure in an assessment, and we have seen that. We know that we've seen lots of examples of that. Has your company ever had a claim for compensation by someone who has been a victim of misjudgment on an assessment? I'm not aware of any such case. I'm happy to go and do some research to find out if that has been the case. PIP has been running for two years. I can only comment on the PIP contract, and I'm not aware of that, but I'm happy to go and do some research and provide that back. Would you do that? One of the things that I've been asked by constituents is where there are recourses in all of that. That's obviously one way of recourse, especially if you've used up the last precious days of your life fighting a system that doesn't want to help you. That would be appreciated. Kevin Stewart, you've stated that, at this moment in time, you're contracted by the DWP to carry out those PIP assessments. Could you give us an indication of how much profit Atos is likely to get from that contract to deal with PIP assessments? Back to my earlier point about the fact that we had to tackle the backlogs last year. Clearly, we did that by increasing the amount of health professionals we had available and the amount of additional estate across all of our contractual area. Clearly, with any contract of the size, you have to take a long-term view as to the return on profitability expected from a contract, which is focused on delivering those assessments as quickly as possible with the required amount of health professionals. We would expect, over the duration of the contract, to return a profit in terms of what that is. However, I'm not in a position to talk about given the way that we're currently investing in health professionals and additional assessment rooms to ensure that we don't run back into the backlogs again and that we're able to deliver that service as quickly as possible. Is it likely to be in the millions of pounds of profit that you will make over the long term? If you require a more detailed response of that, I'm happy to go in and see what I'm able to share with the committee and send that on. I think that we'd be grateful to get an idea of how much you are likely to make in profit over the course. I realise that Atos were unwilling to give figures for the work capability assessment contracts, but then you gave out documentation that showed that, in Scotland and in the north of England, over the piece that you were likely to make £40 million, it would be good for us to get an indication, convener, of how much you're likely to make in that contract to see if you're being well paid to be the fall, guys. I'm certainly not unwilling, as I say. I'm happy to take that away to find out what I can share, and if that's a problem to do then I'll certainly send the information. That would be helpful, Mr Haley. Just a couple of questions to finish off from myself. I think that you mentioned with me earlier about the duration of the assessment. People not receiving the benefit on the basis of a very short time scale of assessment. Can you give us an idea what the average time of an assessment is in normal circumstances? So our current, what we call average assessment duration, which is the time that actually takes to go through that process, that's currently about an hour and a half. Okay, so it takes an hour and a half, but we're hearing people believing that they've been rejected on the basis of one or two minutes. How does that square? I mean, I don't recognise one or two minutes as an assessment duration. Clearly the most important thing that we deliver is the actual assessment, the face-to-face assessment, and that we've always pided ourselves in being the fact that that takes as long as it takes, and to capture all of the information that Dr McKillop has mentioned. And on average that is taking about 90 minutes, but everybody is, every individual case is different, and therefore they will require the amount of time that they need to go through the assessment to make sure that all the information is being captured. Okay, when we visited the ATOS assessment centre to discuss the work capability assessment, one of the things that we learned from that experience was the importance of further medical evidence, and we also discovered that the GPs were only returning about 50% of FME. We're looking to see whether that's improved, we've written to those concerned to see whether there has been an improvement in that situation, but how important is FME to the PIP process and do you have the same authority to obtain FME from GPs, as was the case with the work capability assessment? Further evidence, as you say, is really key to the PIP assessment process, and one of the differences is that individuals who have some evidence, whether letters or other information about their health condition are encouraged to send that in as early as possible in the process, along with their claim, and it's really important to recognise that that evidence doesn't have to be medical, it doesn't have to be from their GP or from a consultant. We tend to refer to further evidence in PIP rather than just further medical evidence, and that's recognising that there are often other people who know perhaps a little bit more about an individual's day-to-day situation than perhaps their GP might, so any information that's sent in along with the case, whoever it's from, will be considered as part of the claim. Are GPs contractually obliged to provide further evidence in relation to PIP as they are with the work capability assessment? We write out to GPs for further evidence where we think that that's going to be helpful before we decide whether an individual can have a paper-based review or we invite them in for a face-to-face assessment. I'm not aware of the contractual arrangements that we have with GPs to provide that, but they are invited to provide further evidence where we think that that will be helpful. So much depends on the individual's conditions, what information has already been provided by the individual and what day-to-day difficulties they have. I think that Kevin Stewart rightly raised the issue of the value of the contract and you've said you'll help us with that, but in relation to Salis, given that Salis is part of NHS Lanarkshire, would the profit that you make from this process, would that be in the accounts of NHS Lanarkshire that would be made available to the public? My convener is that it's a matter of public record and certainly we've previously discussed this within this forum that over the full term of the contract NHS Lanarkshire through Salis expects to bring in income, which will be further invested in our core business of between £1 million to £2 million over the full term of the contract. Can you just remind us of what the full term of the contract would feature as part of our annual accounts on NHS Lanarkshire? That's what I suspected. What is the duration of the contract? When is the contract scheduled to be completed? The current contract? I should probably add. The first break in theory in the contract is July 17 and the contract comes with the option of perhaps plus one or plus two years after that. We don't take, Salis don't play any part in the negotiation of the contract, that would be between the Department of Work and Pensions and ATOS. Okay, but the contract that you have with ATOS was approved by the Scottish Government before it was signed. We sought approval from the Scottish Government prior to signing. Okay. Mention was made earlier also of requests for a moratorium, if you like, or the ending of the roll-out of PIP. If NHS Lanarkshire were affected by that because Salis would stop doing PIP assessments, that would be at a cost to NHS Lanarkshire. Does NHS Lanarkshire factor in the projections on profit, i.e. would that form a loss in projected income to NHS Lanarkshire if there was to be a moratorium? I'm happy to respond, convener. Clearly in our initial consideration of involvement in the contract, due consideration was given to risk assessment and that continues to be the case. NHS Lanarkshire's financial exposure around the continued relationship, the contractual relationship in relation to PIP, is largely in relation to the staff that we employ. There are some terms of leasing of properties associated with that, but the main exposure to risk would be in relation to the 50 staff that we currently employ in delivering the clinical staff that have been mentioned. NHS Lanarkshire employs 12,000 staff and we have an on-going very efficient process in relation to staff redeployment relating to organisational change anyway and that 50 staff number in terms of our assessment of risk is not something that we are unduly concerned about. What percentage of Salis's overall work commitment is taken up with the PIP assessments? Salis is split into our core services that we deliver for NHS Lanarkshire in terms of occupational health and safety, which is protected and entirely separate to any commercial activity that we are involved in. Of our commercial activity, PIP probably takes up round about, I'd probably estimate around about 40 per cent, of our overall commercial activity. That's helpful to understand. Again, mention was made of the fact that PIP will be at some point in the future the responsibility of this Parliament and the Scottish Government. I know that you've made it clear that you're not responsible for the policy that drives PIP, but from your perspectives, do you have any recommendations that you would make to the Scottish Government for changes to the PIP policy? I think that at some stage there's going to be a wider discussion that will involve the Department for Work and Pensions and Scottish Government about the move of the devolution of welfare into Scotland. Clearly, we would need to be part of that discussion, given our experience, along with Salis and Premex, in terms of how we've been delivering PIP and the continuous improvement of the service that we've seen over the two years and would hope to continue to see. We would welcome any conversation to be involved in the on-going improvement of PIP as a service, but until such time as we're invited into those discussions, if indeed they're planned in the very near future, we'd have to wait and see. I'll leave it at that. I thank you for coming in front of us this morning again to reiterate our thanks to opening up your facilities to allow us to come in and see just how it operates on the ground, albeit in a mock capacity. It was certainly advantageous to allow us to speak to the health professionals involved, but also to see the types of facilities that people are visiting when they come in for assessments. I think that was valuable in terms of informing the committee. We're going to continue to monitor the development of PIP, so you may find that you're going to be invited back to speak to us again, but I thank you on behalf of the committee for agreeing to come before us this morning and for the information that you have provided and what you have committed to provide in writing. We look forward to receiving in the future and we'll continue that dialogue. Thank you very much. I don't really need to close the meeting to allow the witnesses to attend. We do have another item on our agenda, but that was only there in case we didn't get sign off of our report on women and social security, but we've managed to get that by correspondence, so we don't need to discuss anything under agenda item 2. I can close the meeting by pointing out that our first meeting will be in September when we'll start our inquiry into the practical implementation of social security schemes outlined in the Smith agreement. Thanks to everyone this morning. I'll close the meeting at that point. Thank you.