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B l u e B a d g e e l ig ib il it y a s s e s s m e n t:    In d e p e n d e n t R e v ie w f in d in g s                 ...
Background Extensive independent review of Blue Badge administration  and assessment good practice in England for DfT... ...
National Blue Badge scheme data 2010 DfT Blue Badge scheme stats...      1,053,000 BB applications (418,000 new / 635,00...
1: Scheme publicity and information             •   Provide inf ormation f or applicants, f or example online and in print...
Critical dependencies BB application form:    Does it provide useful information about applicant’s condition?    Declar...
Early findings were bewildering... Multitude of different approaches to BB admin & assessment Partly due to different LA...
Detailed results made case for IMAs... 63% of BB applicants are subject to further assessment Most have some form of wal...
And prompted new legislation...“In order to ensure a fairer allocation of badges, we havetherefore amended legislation to ...
Other key findings also helpful... OTs/Physios are most appropriate healthcare professionals Suggested caseloads for hea...
Eligibility assessment ‘Core principles’ Developed for DfT BB Scheme Guidance in England A way of enabling DfT to emphas...
Core principles – Desk Assessments Get OTs/Physios involved in the design & staff training Devise an objective quantitat...
Core principles – Desk Assessments Cross-check self-reported information on walking ability with  disability/condition an...
Overview of desk-based assessmentsPro’s: Offers uniformity of outcomes Significantly reduces assessment costsCon’s: Goo...
Core principles – IMAs Full design & delivery by health professionals (OT/Physio) Check applicant’s ID at start of asses...
Core principles – IMAs Use functional movement tests as appropriate Observe and time the applicant walking a known dista...
Core principles – IMAs Ask applicant about where & how they normally walk Consider (correct) use of walking aids – could...
Core principles – IMAs Decision is a holistic view of all information gathered...   “Consider each aspect of walking (pai...
Overview of IMAsPro’s: Most accurate way of determining eligibility Applicants feel their case has been fully considered...
Golden rules Always refer to the eligibility criteria for BB Scheme Ensure your assessment regime complies with the foll...
Thanks for your time today...ITP’s independent review of Blue Badge Scheme for DfT:http://www.dft.gov.uk/publications/blue...
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Blue badge reform assessments - event - 28 march 2012 - presentation - itp

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Blue badge reform assessments - event - 28 march 2012 - presentation - itp

  1. 1. B l u e B a d g e e l ig ib il it y a s s e s s m e n t: In d e p e n d e n t R e v ie w f in d in g s Neil Taylor Integrated Transport Planning Ltd.
  2. 2. Background Extensive independent review of Blue Badge administration and assessment good practice in England for DfT...  Review of 33 local authorities Sep ‘09 – Sep ’10  Evaluate CoE Programme Sep ‘09 – Sep ‘10  Pilot emerging good practices Sep ’10 – Jan ‘11  Prepared updated guidance for DfT June 2011  Final report published August 2011
  3. 3. National Blue Badge scheme data 2010 DfT Blue Badge scheme stats...  1,053,000 BB applications (418,000 new / 635,000 renewal)  86% of new / 93% of renewal applications accepted  906,000 badges issued (558,000 subject to further assessment)  349,000 successful new applications (590,550 renewal)  BB acceptance rates range from 91% - 71% by region  DfT estimate 300,000 medical assessments in 09/10 2011 DfT Blue Badge scheme stats.....  939,000 badges issued (571,000 subject to further assessment)  324,000 successful new applications
  4. 4. 1: Scheme publicity and information • Provide inf ormation f or applicants, f or example online and in printed literature. • Signpost potentially eligible people to the Blue Badge application pathway. • Raise public awareness on the Blue Badge Scheme’s purpose and who is entitled to one. IMA’s influence on ‘The system’ 2: Handling new/renewal applications • Application f orms available in print & online with clear submission mechanism • Of f er support with completing the f orms & request proof of ID and address. • Anti-f raud declarations and provision of applicant’s consent to share inf ormation. 3: Eligibility determination • Processing application f orms when they arrive with the local authority. Local Authority Blue • Check proof of identity/address and determine eligibility assessment pathway. Badge teams Legislation and3a: Without further 3b: Subject to guidance further assessment (152 local systems)assessment • Desk-based assessment of self -reported inf ormation • Telephone contact with applicant (as required)• Check proof of • Ref er applicant f or mobility assessment with OT/Physio (as required) entitlement • Seek specif ic inf ormation f rom applicant’s healthcare prof essional (as required)• Issue/ref use Blue • Site visit to organisational Blue Badge applicant’s premises (as required) Badge • Broad set of Determine eligibility based on recommendations & evidence Blue Badge The Blue Scheme 4a: Administration of unsuccessful applications Badge processes • Write to applicant, explaining grounds f or ref usal and providing an opportunity f or a review, or complaint Scheme • If required, lead applicant through the review or complaint process. If successf ul ref er applicant step 4b (National 4b: Administration of successful applications • system) Applicant to receive Df T’s ‘Blue Badge Scheme: rights and responsibilities’ leaf let and sign declaration on terms of use and awareness of their duty to return the badge if their circumstances change • Applicant to pay Blue Badge issue f ee and be promptly issued aBlue Badge & parking disc Localised5: Ongoing administration practices• Manage standard renewals, with a reminder letter 3 months bef ore expiry• Manage renewals of lost/damaged and stolen badges• Request badges f rom Blue Badge holders registered as deceased• Share inf ormation with parking enf orcement teams where abuse of the Blue Badge is suspected Outputs (number of badges6: Proactive Blue Badge enforcement awarded/refused)• Include Blue Badge checks in routine parking enf orcement inspections• If required, monitor suspected Blue Badge abuse/f raudulent users• If required, withdraw the Blue Badge f rom f raudulent holders/users
  5. 5. Critical dependencies BB application form:  Does it provide useful information about applicant’s condition?  Declarations – information sharing / IMAs Appeals procedures:  Detailed refusal letter heads off many appeals  Separate appeal ‘reviews’ from ‘complaints’  Only ever need to reassess following complaint against procedure  No legal requirement to carry out appeals Re-applications  Does the applicant need to be reassessed?  Opportunity to check fluid conditions
  6. 6. Early findings were bewildering... Multitude of different approaches to BB admin & assessment Partly due to different LA organisational structures/geography Many authorities aiming to reduce BB scheme costs... ... but some seemed to have gone too far:  We use a desk-based scoring system (‘some people probably lie’)  No IMAs at all (‘admin staff meet borderline applicants’)  No renewal reminders (‘too expensive’)
  7. 7. Detailed results made case for IMAs... 63% of BB applicants are subject to further assessment Most have some form of walking impairment Research study pilots found that using IMAs...  Reduce costs by 30% compared to GP assessments  Reduce award rates from 95% (GP) to 70%  Achieve lower rates of appeal (20% IMA, 39% GP)  Result in fewer successful appeals (21% IMA, 28% GP)  Accelerate the eligibility decision-making process
  8. 8. And prompted new legislation...“In order to ensure a fairer allocation of badges, we havetherefore amended legislation to prescribe that eligibilityunder 4(2)(f) be confirmed through use of an independentmobility assessment unless the authority is satisfied in aparticular case that it would not assist it in deciding whetherthe applicant was eligible (i.e. that it is self-evident that theapplicant is eligible or ineligible). The legislation alsoprescribes the use of Independent Mobility Assessments(IMAs) in assessing eligibility under 4(2)(g) which coverstemporary badges to people “unable to walk orvirtually unable to walk by reason of a temporary orsubstantial disability which is likely to last for aperiod of at least 12 months”.Local Authority Circular November 2011
  9. 9. Other key findings also helpful... OTs/Physios are most appropriate healthcare professionals Suggested caseloads for healthcare professionals:  Assessment: 30 mins, Decision & reporting: 10 mins  7-8 applicants /day maximum IMAs have been implemented successfully by all types of LA Desk-based assessments are effective filtering tools  Identify clearly eligible/ineligible applicants  Piloted approach was 91% accurate compared to IMAs
  10. 10. Eligibility assessment ‘Core principles’ Developed for DfT BB Scheme Guidance in England A way of enabling DfT to emphasise to English local authorities what should go into an assessment, without prescribing a specific approach. Tested through piloting and rigorous evaluation Supported through legislation coming into force in Sept 2012
  11. 11. Core principles – Desk Assessments Get OTs/Physios involved in the design & staff training Devise an objective quantitative scoring mechanism Can be completed by (trained) administrative staff members Require applicants to fully complete BB application form
  12. 12. Core principles – Desk Assessments Cross-check self-reported information on walking ability with disability/condition and local health services accessed Additional information can be sought by phone Look up on a map where applicant walks to from their home
  13. 13. Overview of desk-based assessmentsPro’s: Offers uniformity of outcomes Significantly reduces assessment costsCon’s: Good filtering tool but not suitable for making a decision on every applicant. Recourse to an IMA where a decision can’t be made
  14. 14. Core principles – IMAs Full design & delivery by health professionals (OT/Physio) Check applicant’s ID at start of assessment! Cross-check information from applicant’s application form Observe & record the applicant’s manner of walking
  15. 15. Core principles – IMAs Use functional movement tests as appropriate Observe and time the applicant walking a known distance Observe resting, pauses and amount of time taken to walk MRC dyspnoea scale for breathlessness & observe
  16. 16. Core principles – IMAs Ask applicant about where & how they normally walk Consider (correct) use of walking aids – could an aid help? Discuss (self-reported) pain and observe applicant
  17. 17. Core principles – IMAs Decision is a holistic view of all information gathered... “Consider each aspect of walking (pain, breathlessness, speed, distance, use of walking aids and manner of walking) first in isolation, and then in combination, to reach a decision as to whether they combine to mean the applicant is unable or virtually unable to walk.”
  18. 18. Overview of IMAsPro’s: Most accurate way of determining eligibility Applicants feel their case has been fully considered Reduces number of consequent appealsCon’s: Extends the decision-making process Expensive and time consuming for all parties
  19. 19. Golden rules Always refer to the eligibility criteria for BB Scheme Ensure your assessment regime complies with the following hierarchy of rules/guidance: 1. Primary legislation 2. Secondary regulations 3. Code of Practice & Process Model 4. Research evidence
  20. 20. Thanks for your time today...ITP’s independent review of Blue Badge Scheme for DfT:http://www.dft.gov.uk/publications/blue-badge-good-practice-review Neil Taylor T: 0115 988 6903 ITP Nottingham E: taylor@itpworld.net

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