Request

Under the freedom of information Act 2000, l am requesting the following information outlined below. This is in relation to AW33E applications.

1. Any guidelines/ policies or documents you hold in relation to determining the rationale for granting tier 1 and tier 2 ill health retirement awards. Not just NHS but Medigold documents. This would be also be in relation to the NHS pension scheme of 1995 and 2015.

2. Any documentation in relation to applicants applying for ill health during the covid period, including lockdown and following.

3. Did you consider the difficulty in obtaining and seeing medical professionals during this period? If so can you provide any documents in relation to this and the advice you gave your medigold Doctors during this period?

4. If you required further medical evidence to assess ill health retirements, can you provide me with the figures in relation to this during 2018 - 2024 ( or the most up to date you hold) where you sought further advice from NHS consultants or other clinicians in relation to the evidence provided by applicants, when submitted to medigold.

5. If you are uncertain regarding applications and require further medical evidence, what procedures do you follow? Can l be provided with the documents related to this?

6. How do you decide upon who is to be granted tier 1 with no option for reassessment v those offered the option of reassessment? Can l be provided with the guidelines and any associated documentation?

7. Can you provide the figures for applications for ill Health retirements for the periods 2018-2024 ( 2024 can be what is presently known in months)
   This is to include:

2018 to 2024 in individual years. For clarity l have specified the information l require for each year. (2024 for months)

A. Number of applicants.

B. Those refused and those granted and the tiering awarded.

C. Of those refused, who was granted tier Tier 1 and Tier 2 on appeal.

D. How many were granted tier 1 on original application and how many tier 2?

E. How many were granted tier 1 and appealed for tier 2, the figures for those awarded and those who remained at Tier 1. F. How many were granted tier 1 with no option of reassessment v those with an option for reassessment.

G. Of those awarded the option for reassessment how many were subsequently awarded tier 2 on reassessment and those declined.

H. How many were awarded tier 1 with the option of reassessment but opted for appeal instead?

I.SIHC refused and awarded.

J. SIHC, those refused and awarded on appeal.

K. Guidelines for SIHC

I am requesting guidelines for ill health retirement, any covid documents, medigolds advice to their doctors during covid and the above statistics for ill health retirements and appeals. I do not believe any of this falls outside the guidelines for non disclosure or time restraints under the Freedom of Information Act of 2000.

Response

I can confirm that the NHSBSA holds some of the information you have requested.

Medigold are independent medical advisors and have been used by NHS Pensions since 2017. They’re specially trained occupational health physicians and their role is to assess an applicant’s capacity or incapacity for work against the NHS Pension Scheme regulations. They’re experts in seeking, evaluating and using the evidence of clinical specialists to assess the functional consequence of an applicant’s medical condition and how that change in function impacts on their capacity or incapacity for work. Medigold’s independent medical advisors carry out this assessment of the medical evidence and offer a recommendation to NHS Pensions. They can also commission further medical evidence if they consider it relevant and helpful to their assessment.

Question 1. Any guidelines/ policies or documents you hold in relation to determining the rationale for granting tier 1 and tier 2 ill health retirement awards. Not just NHS but Medigold documents. This would be also be in relation to the NHS pension scheme of 1995 and 2015.

I am writing to advise you that following a search of our paper and electronic records, I have established that the information you requested is not held by the NHS Business Services Authority. The training materials and guidance are issued by Medigold and remains their intellectual property. Medigold are a private limited company and is not subject to the Freedom of Information Act

Question 2. Any documentation in relation to applicants applying for ill health during the covid period, including lockdown and following.

I am writing to advise you that following a search of our paper and electronic records, I have established that this is not held by the NHS Business Services Authority.

Question 3. Did you consider the difficulty in obtaining and seeing medical professionals during this period? If so can you provide any documents in relation to this and the advice you gave your medigold Doctors during this period?

I am writing to advise you that following a search of our paper and electronic records, I have established that there was no specific guidance issued to the Medigold doctors during this period.

Question 4. If you required further medical evidence to assess ill health retirements, can you provide me with the figures in relation to this during 2018 - 2024 ( or the most up to date you hold) where you sought further advice from NHS consultants or other clinicians in relation to the evidence provided by applicants, when submitted to medigold.

Further medical evidence was sought in 5882 cases.

Question 5. If you are uncertain regarding applications and require further medical evidence, what procedures do you follow? Can l be provided with the documents related to this?

I am writing to advise you that following a search of our paper and electronic records, I have established that the information you requested is not held by the NHS Business Services Authority. The training materials and guidance are issued by Medigold and remains their intellectual property. Medigold are a private limited company and is not subject to the Freedom of Information Act.

Question 6. How do you decide upon who is to be granted tier 1 with no option for reassessment v those offered the option of reassessment? Can l be provided with the guidelines and any associated documentation?

I am writing to advise you that following a search of our paper and electronic records, I have established that the information you requested is not held by the NHS Business Services Authority. The training materials and guidance are issued by Medigold and remains their intellectual property. Medigold are a private limited company and is not subject to the Freedom of Information Act

Question 7. Can you provide the figures for applications for ill Health retirements for the periods 2018-2024 ( 2024 can be what is presently known in months)
This is to include: 2018 to 2024 in individual years. For clarity l have specified the information l require for each year. (2024 for months)

A. Number of applicants.

17,700
The number of decisions will not always equal the number of applicants due to various factors including withdrawal of applications, duplication, or applicants being members of multiple schemes.

B. Those refused and those granted and the tiering awarded.

Rejected applications - 2626 Accepted – 13,201

C. Of those refused, who was granted tier Tier 1 and Tier 2 on appeal.

Of those refused, a combined 779 members were granted Tier 1 and Tier 2 on appeal.

D. How many were granted tier 1 on original application and how many tier 2?

Accepted - Tier 1 - 4695 Accepted - Tier 2 - 8506

E. How many were granted tier 1 and appealed for tier 2, the figures for those awarded and those who remained at Tier 1.

Granted at Tier1, appealed for Tier 2 – 349 Granted Tier 2 after an appeal - 213 Remained at Tier 1 - 136

F. How many were granted tier 1 with no option of reassessment v those with an option for reassessment. G. Of those awarded the option for reassessment how many were subsequently awarded tier 2 on reassessment and those declined. H. How many were awarded tier 1 with the option of reassessment but opted for appeal instead?
I.SIHC refused and awarded.
J. SIHC, those refused and awarded on appeal.

We have considered this request under the Freedom of Information Act 2000 (FOIA) and are issuing a refusal notice under section 17 of the FOIA. The NHSBSA does hold the requested information; however, we estimate that the cost of compliance with the request would exceed the appropriate limit under section 12 of the FOIA.

We estimate that the cost of complying with your request would exceed the non-central Government limit of £450. The limit has been specified in The Freedom of Information and Data Protection (Appropriate Limit and Fees) Regulations 2004

https://www.legislation.gov.uk/uksi/2004/3244/contents/made

and represents the estimated cost of one person spending 18 hours in determining whether the NHSBSA holds the information, and locating, retrieving, extracting and checking the information.

To answer questions F-I, would require a manual search of more than 17,000 cases. We estimate a minimum of 15 minutes per case.
  17,000 cases x 15 minutes = 4250 hours 

K. Guidelines for SIHC

I am writing to advise you that following a search of our paper and electronic records, I have established that the information you requested is not held by the NHS Business Services Authority. The training materials and guidance are issued by Medigold and remains their intellectual property. Medigold are a private limited company and is not subject to the Freedom of Information Act