Universal credit in hospital
Kirsty McKechnie describes some problems and possible solutions for claiming and maintaining universal credit (UC) in hospital.
In response to some case studies received by the Early Warning System (Scotland), CPAG in Scotland recently held a roundtable event, gathering together advice and health professionals to look at claiming and maintaining UC while in hospital. The discussion was both illuminating and concerning.
A number of issues were raised in relation to making a claim for UC.
•Access to internet/mobile phone signal varies between hospitals and often locations within hospitals.
•Lots of patients do not have access to smartphones, tablets or laptops.
•Patients often do not have the necessary information required to set up a UC claim and to confirm their ID with them.
•Poor success at making claims for UC over the phone (and even if successful, patients are still expected to maintain their claim online).
Experience of advice projects based in hospital
We heard from two advice projects based in hospitals about what helping patients to claim UC in hospital entails. They start by having a ‘pre-appointment’ with the client to identify the information that will be required so that a patient’s family member or friend can bring this in from the patient’s home (requiring a great deal of trust on the part of the patient). The advice projects have named contacts at the job centre who have been assisting where it has not been possible to obtain some ID and report this is working well.
The advisers take laptops to the wards where possible (devices are not always allowed on wards in case they interfere with medical equipment) and they help people to set up emails and to claim online. Advisers are concerned about security issues in relation to patients entering personal data on to the project laptops. Where using laptops is not possible, the only alternative is phoning from the ward and putting the patient on speakerphone, undermining personal privacy and data protection. For some patients (eg, in the spinal unit), it is simply not possible to hold a phone.
Once UC claims are set up, patients are expected to maintain their claims online, even though they may not have a device on which to access their journals. Examples were raised of people being sanctioned, despite the DWP being alerted to the fact they were in hospital. The DWP official present at the meeting stated that staff had been given clear directions in November 2018 about safeguarding while people are hospital, however it was confirmed that some of the sanctions had been imposed after that date.
The advice projects reported that helping patients with UC in hospitals is hugely time consuming and largely involves firefighting issues as they arise. Implicit consent is a considerable barrier to advisers supporting patients, as is the amount of time they have to wait to get through to the UC helpline. Based on the number of people assisted, it appears that these advice projects are doing less work than before UC was introduced, but this is not reflective of the fact that the UC cases take much longer and impact on the number of people who can access the service. Morale is low and staff have been lost to ‘burn out’ as a result of the extra pressure UC has placed on their workload.
Hospitals with no welfare rights support
What was most worrying from this discussion was the amount of work required to help someone set up and maintain a UC claim in hospital by experienced advice professionals based on site. Given that many hospitals do not have an equivalent service, the Early Warning System (Scotland) would be interested to hear of cases where clients have not had access to support to claim UC in hospital and what their experience has been.
Hospital inpatients can access the Citizen’s Advice Help to Claim service, but this is mostly limited to assistance by phone or online, which does not get round the access to devices/ internet issue experienced by many patients. The Help to Claim funding does not cover visiting everyone in hospital who needs to claim UC. DWP visiting officers can support claimants to claim on their own device (not DWP devices) or to claim by phone.
Possible solutions
Advisers reported that if people were only going to be in hospital for a short period of time, they would suggest waiting until they were discharged to claim UC from home and request that their award be backdated for one month on the basis they were unable to claim earlier because they were in hospital. However, there is no guarantee that it definitely would be backdated.
One of the basic requirements of UC is that the claimant must sign a claimant commitment. If a claim has been submitted, either before the claimant enters hospital or during her/his stay but s/he has
•the claimant cannot accept a claimant commitment because s/he lacks the capacity to do so; or
•there are exceptional circumstances in which it would be unreasonable to expect the person to accept a claimant commitment.
These rules may be useful while someone is in hospital, or to argue that a UC award should startfrom an earlier date where the claimanthas subsequently signed a claimant commitment.
The solutions appear to be limited in what seems to be a situation where people may face significant barriers to claiming and maintain claims for UC. There is more work to be done to identify the scale of the issue and to identify practical and policy solutions.
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