Are the Atos Medical Tests Illegal ?

RazWaz

ATOS Origin refuse to make known any of the internal specification, coding or workings of LiMA. This has been rebuffed through a number of Freedom of Information Requests. This refusal ATOS justify on the basis of "commercial interest". LiMA guides medical professionals through the completion of the medical report form IB85 from the source IB50 document.

Prompting operators to obtain and enter relevant information and complete all required sections of the report, one of the key features of LiMA is that it provides intelligent support! by identifying logical outcomes!. LiMA automatically suggests which PCA descriptors are satisfied based on the evidence recorded, and showing what evidence establishes its conclusions in relation to each descriptor. This only means that the conclusion is consistent. Logical consistency is not the same as being true. This is something recognised since David Hume. However, the decision to make these PCA descriptors available are carried out by LiMA, not the Operator.

After entering the claimant!s choice of PCA descriptors from the information given on an IB50 questionnaire, the operator records the claimant's diagnosis; diagnosis history; medication (including side effects); treatment; social and occupational history; and activities carried out on a typical day.

The examination findings are then entered LiMA restricts the examinations that must be completed from the IB50 information and opens a specifically designed screen relating to each examination. Again, LiMA restricts the decisions that can be made on a commercially secret basis.

The doctor then has to record observed behaviour relating to relevant sub-groups of physical functionality (e.g. 'sitting, rising, bending').

A wide variety of standard terms and phrases relating to each section of the form are available for selection, as well as the facility to enter free text. All, except the free text, are entirely controlled by the LiMA software.

Understanding how LiMA transforms IB50 to IB85 is a commercial secret. Thus ATOS are, implicitly, accepting a duty of care to 'get it right'. ATOS Origin are also accepting an implied duty of care to support the professional standards of Doctors or Nurses (or even professionally trained monkeys) in allowing them to make decisions that they are prepared to stand by.

A number of commissioners decisions have considered LiMA impact on the PCA, highlighting some problems.

In CIB/664/2005 (Bulletin 188, p15),

the commissioner agreed with the tribunal that the electronic IB85 relating to the claimant was unreliable. It contained nonsensical statements such as Usually can do light gardening for 1 minutes and failed to carry forward relevant findings relating to the claimant's mental state to the choice of the mental health descriptors. The commissioner also queried Lima's emphasis on identifying the claimant's abilities (as opposed to inabilities) and the additional weight given to observed behaviour highlighted in the Technical Manual. He held that the Manual should be available to all tribunals, claimants and representatives to ensure equality of arms, pointing out that:

If the Manual!s advice is followed, the report seen by the claimant and tribunal is not the evidence considered by the doctor (which is itself a computer generated selection) but a selection from that evidence of the most convincing! case. A tribunal has to consider and weigh all the evidence. It may, therefore, need to re-examine all the evidence about each contested descriptor and make its own findings and conclusions, rather than rely on the evidence that the approved doctor considers most convincing!.'

The Commissioner states what any techie would tell you: RTFM. Any LiMA Operator who has not read the manual is in danger of making decisions that are utterly without professional opinion yet bind them, Professionally, to the outcome.

There are several important Commissioner Judgements: CIB/476/2005, CIB/511/2005, CIB/664/2005 (above), CIB/1522/2005, which all criticise the "automated" aspects of LiMA. In the end, the legally binding decisions are based on the IB85 form.

Oldernotwiser

cit_k wrote: »

They dont even need that - the assessments are not there to diagnose illness, or treat patients, or offer any advise to them.

They only training realistically needed (if you forget about legislation, and think real world for a moment) is to be able to operate a computer (terminal).

When employed by ATOS, nurses and physios receive 17/18 days' training in disability assessment, doctors receive 8.

cit_k

Oldernotwiser wrote: »

When employed by ATOS, nurses and physios receive 17/18 days' training in disability assessment, doctors receive 8.

As I said, if you forget about legislation, which requires them to hold a qualification is disability assessment (convientently ATOS train and certify their own assessors, odd seeing as their speciality is writing computer software..) then its not really needed.

They dont 'think' at assessments, they follow a strict computer generated script. Even the report is written for them.

They dont actually need to be trained in anything to do the assessment, in any other regard than its a legal requirement to satisfy the legislation.

Brassedoff

Yet again someone comes on here with what on the face of it looks to be a valid point as far as the law is concerned.!

Another who says they work in the legal field supports the premiss that there may be a Prima facie case for appeals, something I alluded to a week or so ago. I have a law degree (University of Warwick, BA (Hons)1991)!
and wanted to go further and possibly receive my call to the commercial bar, but chose a different path. I still had to apply my knowledge through the years, even attending the occasional refresher, have read the act and would question the assessors level of competence.

If you look in my case (invasive surgery, neuropathic pain, irreversible nerve damage, ongoing problems, on and on and on), a physio (who I see each week on several occasions and defers to my neurosurgeon) or a nurse practitioner, would not have the required level of professional competence as required under the BMA's proposals outlined in 2007 if I am correct. Any opinion or decision would have to be over turned on the basis of the assessor level of competence and practice history:

1. !Have not got the specialist training to enable an opinion based on their level of competence.
2. The two I have outlined would be from a different branch of medicine therefore one would have to defer to the others more learned experience.
!3. It is a breach of the 2007 regulations (BMA's) to provide a professional opinion outside that of your specialty.

Could you argue that the change in the rules would also be a breach of articles 8 & 14 of the HRA 1998. With the interpretation of being forced despite higher medical evidence to the contrary to work is in breach or even 4(1) of the act with respect to the £1.00 workfare proposals?

When called, I intend to record the examination and take a "friend" to take contemporaneous notes. I have absolutely nothing to worry about with respect to my condition, but there is no legislating for quotas!


!

WhiteHorse

Oldernotwiser wrote: »

When employed by ATOS, nurses and physios receive 17/18 days' training in disability assessment, doctors receive 8.

Wow, as little as that, for making decisions that could destroy someone's life.

ukmike

When called, I intend to record the examination

Have you any idea just how impossible that will be?No one has ever managed to do it yet.They insist on so many technicalities to be done & at the end of the day the doctor/nurse can simply refuse to be recorded!

hrafndot

I think that is no longer the case, I am aware that they have exacting stipulations about professional recording equipment, but I think this has been challenged and thus people have recorded the medical.

ukmike

hrafndot wrote: »

I think that is no longer the case, I am aware that they have exacting stipulations about professional recording equipment, but I think this has been challenged and thus people have recorded the medical.

Havn't heard that,but even so,all the doctor/nurse has to do is to refuse to be recorded & thats the end.

cit_k

ukmike wrote: »

Havn't heard that,but even so,all the doctor/nurse has to do is to refuse to be recorded & thats the end.

Yes, the DWP have changed stance, and are reassessing if it should be allowed, in the meantime they have a procedure where people can request their medical to be recorded.

(see tcell.org.uk for more details).

Failing that, you can still record covertly, nothing stopping you at all, and many people have already done so (including myself more than once)

ukmike

Failing that, you can still record covertly, nothing stopping you at all, and many people have already done so (including myself more than once)

Which wont be accepted for obviouse reasons!!(i.e.,can easyly be edited by yourself)