Flaws in the disability benefit system were “the predominant and only acute factor” leading a young disabled mother to commit suicide, a coroner concluded.
Gordon Clow, deputy coroner for Nottingham and Nottinghamshire, yesterday (Wednesday) highlighted 28 separate ‘issues’ with the administration of the Personal Independence Payment System (PIP) that contributed to the death of Philippa Day, 27, from Nottingham.
It took more than two hours for the coroner to read his findings and conclusions, after a nine-day * inquest that revealed multiple failures of both DWP and its private sector contractor Capita over the 11 months which preceded Philippa’s death in October 2019..
Clow ended by telling DWP and Capita that he had decided to issue them with Future Death Prevention (PFD) reports, which will require them to think about how to make changes to the PIP system to avoid other deaths of claimants.
DWP will now need to review the mental health training provided to its call managers and poor record keeping, while Capita will need to review the process to change where and how assessments are done and ensure that letters issued about this process “is correct”. and [do] do not create unnecessary distress ”.
He rejected suggestions made by DWP and Capita during the investigation that only a few individual errors were made in processing Philippa’s claim, and instead concluded that there were significant systemic flaws.
The coroner said that Philippa (on the picture). attend a face-to-face assessment.
Among the 28 “issues” he highlighted were repeated failures to record in his file that she needed additional support for her claim; and the erroneous decision to withdraw her benefits after DWP erroneously concluded that she had no “good reason” for not returning an application form.
He also highlighted the lack of response to the mental distress she showed during a call to a DWP telephone agent; the refusal to allow Philippa a home assessment; and “institutional reluctance” to accept over the phone testimony from professionals such as its community psychiatric nurse (CPN).
The 28e, and the latest issue was Capita’s refusal to agree, despite a phone call from her CPN the day before she was found unconscious – and repeated warnings earlier – that “require a face-to-face assessment in a clinic endangered Philippa’s safety. ”.
The coroner concluded that there were “deficiencies in the system’s ability to process PIP claims without causing unnecessary distress to claimants,” including training issues for call managers and assessors. disability claim, DWP record keeping, advice on additional support for applicants, and inaccurate information. DWP match.
He also said there was an “institutional working hypothesis at DWP that documents that are not in the applicant’s file are missing because the applicant did not send them.”
Clow also pointed out flaws in Capita’s initial review and the change in assessment processes.
Philippa’s unconscious body was found by her sister and father on August 8, 2019, just days after she was told she would have to go to an assessment center for a face-to-face meeting. in order to decide on his PIP request.
They found her lying on her bed at her home in Nottingham. On the pillow next to her was Capita’s letter telling her that she should report for the appointment at the Nottingham Assessment Center.
She was taken to hospital but later died after more than two months in a coma.
The coroner did not return a verdict of suicide, concluding on the contrary that he could “not be convinced that it was more likely than not that Philippa wanted her dead”, even though she was responsible for being. committed suicide.
But he said he was “satisfied, on the balance of probabilities, that Philippa intended to harm herself and endanger her life” by her actions on August 7 or 8, 2019, which led to his death.
He concluded that there were many factors that led to his decision to put his life in danger.
But he said that “the combined impact of the successive destabilizing incidents caused by the problems processing his claim was… the predominant factor, and the only acute factor” which led to this decision.
Philippa was diagnosed with type 1 diabetes when she was 18 months old, then diagnosed with emotionally unstable personality disorder, anxiety, depression and agoraphobia.
She lived a “chaotic” life characterized by repeated self-harm, suicidal ideation, and drug and alcohol abuse, as well as repeated admissions of inpatients to mental health units, but the investigation found that ‘she received constant, dedicated and close support from her family and healthcare professionals.
She had been claiming a Disability Living Allowance (DLA) for her diabetes since the age of 16, but had started a new application for PIP in November 2018, hoping to gain additional support for needs related to his sanity.
Her PIP claim form appears to have been lost by DWP, according to the investigation, after she released it in January 2019, and her DLA was shut down that month for not returning it.
Disability Information Service (DNS) reported last week how a secret DWP investigation into her death found that due to her mistakes Philippa’s total benefits fell from £ 229 per week to just £ 73 per week for four and a half months, while loan repayments from the Social funds amounted to £ 12.43 per week were deducted from £ 73, leaving him just over £ 60 per week to live on.
The investigation learned how Philippa had lived through months of distress over DWP’s decisions to cut her disability benefits when she lost her claim form, and then to confirm that decision, along with the time he had. needed to reinstate her benefits and deal with a new claim.
The DWP’s mistakes caused her serious financial hardship, the coroner said, and led her to take out payday loans that she was unable to repay.
DWP and Capita had both been told of her history of significant mental distress and mental health hospitalizations, that she was agoraphobic and would be unable to cope with attendance at the assessment center.
Philippa’s sister, Imogen, said last night that the family wanted “continuous and systemic change.”
She said they believed that DWP’s treatment of her sister (known to her family as Pip) “had a direct impact on her mental state and was ultimately the reason for her death.”
“She was desperate because of the depths she had sunk into, she saw no way out of the debt and poverty in which she lived.
“Pip’s poor mental health meant that she was unable to handle the battle with the DWP for the reinstatement of her benefits.
“The stress of the conflict with the DWP made her even sicker.
“The support of her community psychiatric nurse and her family has supported her. But the constant cold and unsympathetic wall of resistance she encountered at Capita and the DWP was more than she could handle.
“The refusal of a home assessment by Capita was just too much for Pip to handle. We think she couldn’t take it anymore.
She said she was “very happy” with the coroner’s conclusions, and praised his “very full and thorough investigation.”
Merry Varney, partner of notaries Leigh’s Day, who represented the family at the inquest, said the coroner’s decision to release PFD reports was “extremely important” as DWP and Capita would be required to respond to them, while their responses would be released.
She told DNS that the example set by the coroner and his “willingness” to investigate the role of the DWP “should be very powerful messages for other coroners.”
She added: “I hope Pip’s family and everything they’ve done will help other families who may have been in this situation to feel that they can come forward and that maybe there is. a way to help them and for them to obtain justice “.
In a statement, Capita apologized to Philippa’s family “for the errors made in processing her application and the additional stress that was caused to Philippa”.
A spokesperson said: “We have strengthened our processes over the past 18 months and are committed to continuously working to provide high quality, empathetic service to every requester.
“In partnership with the DWP, we will act on the coroner’s findings and make further improvements to our processes. “
The DWP offered its “sincere condolences” to the family and said it “would carefully review the coroner’s findings.”
DNS asked if he would apologize to the family for his failures, but DWP had not responded by noon today.
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