Home Office circular 052 / 2003
The Police Pension Scheme - Police Medical Appeal Boards
Dear Chief Officer
1. HOC 43/2002 advised that the Home Office-led Contract Panel were working on securing a contract with the supplier of a new system of medical appeal boards which will replace the present system of single independent medical referees. This contract has recently been awarded to Aon Health Solutions (AHS). The purpose of this circular is to inform you of the new arrangements and to provide the guidance needed for the orderly processing of appeals. It should be brought to the immediate attention of force personnel officers, force medical practitioners, administrators of the Police Pension Scheme, Finance Officers and those responsible for payment of invoices.
- The following are key points about the new arrangements:-
The boards (normally consisting of 3 members) are to be known as Police Medical Appeal Boards and will be held on a regional basis.
They have been set up in accordance with the PNB Agreement of May 2002 to deliver a fairer and more robust appeals system.
The standard charge for a 3-member Board is £2,345 (exclusive of VAT). AHS will send invoices direct to Police Authorities.
The duration of the contract is 3 years with provision for two 12-month extensions up to 5 years.
The operational date for commencement of services is 10 November 2003.
The earliest date for commencement of appeal hearings is 12 January 2004.
Two further circulars will be issued: the first in late November 2003 with agreed final versions of guidance and forms and a full list of changes to the Police Pensions Regulations 1987 to be introduced from 10 November 2003; and the second when the Regulations have been amended. See paragraphs 32-33.
Contact points for AHS and the Home Office are given at paragraphs 34-36
- The guide to how the new appeals system will operate is at paragraphs 54 to 100 of the PNB’s overarching draft Guidance on Ill-Health Retirement. This extract (“The Appeals Guidance”) is at Annex A. The Appeals Guidance is subject to final agreement by the PNB and is attached for information. Although any changes are expected to be relatively minor, the Guidance is incomplete and should be given a restricted circulation. It must be replaced by the final agreed version which will be issued next month with a further HOC - see paragraph 32. What follows is not a full summary of the Appeals Guidance but draws attention to some of its key elements and gives additional information about the contract.
Commencement of services and commencement of hearings
4.. AHS will be ready to take receipt of appeal notifications from the operational date for commencement of services of 10 November 2003. All outstanding appeals, any new appeals notified to the Home Office before this date, and any appeals notified to AHS before the operational date will be processed under the current system of medical referees appointed by the Home Office..
5.. AHS will give the parties at least 2 months’ notice of the hearing date. The Boards will start to hear appeals from 12 January 2004 but many of the first appeals under the new system will be scheduled for February 2004.
Changes to Police Pensions Regulations 1987 and to the Home Office’s Commentary on the Regulations
- The switch from single medical referees to Police Medical Appeal Boards in respect of appeals notified from the operational date of 10 November 2003 will be introduced administratively. The other important changes to be introduced administratively with effect from 10 November, which Forces need to be immediately aware of, are:-
all decisions under regulation H1 are to be in the form of a report, whereas at present in cases where injury awards are considered alone without the issue of permanent disablement the Selected Medical Practitioner (SMP) completes a certificate.
A person dissatisfied with an H1 report is to have 28 days to appeal and a further 28 days in which to state the grounds for appeal, whereas at present under regulation H2(1) and (2) there is a period of 14 days only for giving notice of appeals and there is no requirement to state the grounds for appeal.
Please note that the Force Medical Adviser will continue to be able to act as the SMP in cases not involving the assessment of Permanent Disablement.
A full list of changes to be introduced administratively from 10 November 2003 will be available shortly on the Home Office’s Police Reform website at www.policereform.gov.uk. This list will also be included in the further HOC to be issued next month. A separate circular will be issued when The Police Pensions Regulations 1987 have been amended retrospectively. See paragraphs 32-33.
The Home Office also intends to update Schedule H of the Commentary on the Police Pensions Regulations 1987 to reflect the changes. This will be taken forward together with other ongoing work on the Commentary.
- During the transition to the new system there will be 3 categories of appeals to be processed:-
appeals already notified to the Home Office and those notified to the Home Office before 10 November will be processed under the current system;
appeals (whether against certificates or reports) not notified to the Home Office before 10 November will be processed by AHS under the new system
appeals against reports notified from 10 November will be processed by AHS under the new system
If there are any difficulties in deciding whether appeals should be considered under the current system or the new system being introduced on 10 November, please contact the Home Office. **
- The Boards are located in Birmingham, Bristol, Leeds, London, Manchester, Nottingham and Reading. The locations will be reviewed 6 months after commencement of services. Annex B additionally gives the addresses and telephone numbers for these locations and shows the locations to which Forces have been assigned for appeals involving serving officers, following a consultation exercise carried out by the Home Office. There are different criteria governing where appeals should be held depending on whether the officer is serving or retired; and if the appellant is medically unfit to travel to the nearest Board at its normal location a special appeal hearing will be held as close as possible to or at the appellant’s place of residence. near. Paragraph 66 of the Appeals Guidance refers.
Board Members __
- The Board will consist of at least 3 medical referees as follows:-
Chair (a Consultant in Occupational Medicine with at least Membership of the Faculty of Occupational Medicine);
Second Member (a Consultant or Senior Occupational Physician with at least Associate Membership of the Faculty of Occupational Medicine);
Third Member (a Consultant in the clinical speciality relevant to the appellant’s medical condition on which the appeal is based).
If the appeal concerns two or more different medical conditions, a Consultant Physician with medical expertise relevant to each of the conditions will be appointed to the Board. Paragraphs 67-68 of the Appeals Guidance refer.
Timetable for appeals __
The flowchart at Annex C shows the timescales for each stage of the appeals process (including those preceding the notification of the appeal to AHS). It is important that the Police Authority designates a responsible person to ensure that the Authority fulfils its responsibilities in line with the timetable, particularly as failure to do so may have cost implications.
AHS will work to two main targets in each case: an overall target that it will send the Board’s report to the Police Authority within 16 weeks from its written receipt of the appeal case papers; and a post-hearing target that it will send the report to the Police Authority within 10 working days of the appeal hearing. In extenuating circumstances, e.g. if more information is required for it to reach a decision or if the Third Member is not available to sign, the target will be extended to 15 days. See also paragraph 19.
Attendance at and conduct of hearing appeals
At paragraphs 78-91 of the Appeals Guidance there is extensive coverage of who can attend the appeal hearing and how it will be conducted. The overall aim is for a hearing to be as informal as possible, consistent with it being conducted in an orderly and business-like way. The appellant is required to attend and it will be helpful if the Selected Medical Practitioner (SMP) also attends. The Board should allow others to attend as well in order for each party to make their case effectively, provided that the numbers involved do not detract from a properly conducted hearing and provided that the Board is clear about the status of each person attending. Other than the appellant and SMP, the categories of attendees are: medical practitioner appointed by either party; non-medical representative of either party to present their case; and appellant’s friend or relative accompanying him/her for moral support. Neither party should need legal representation at the hearing, and the Board’s Chair will allow a party such representation only in exceptional circumstances.
During the hearing the appellant will be medically examined by the Third Member. Only the SMP (or in his/her absence, a medical representative of the Police Authority) and the appellant’s medical representative have a right to attend this examination as observers.
The Board’s decision is final, subject to a review under regulation H3. The Board must reach a decision on any question it is considering on appeal in clear and unambiguous terms. Where there is room for doubt, the Board should reach its decision on the balance of probabilities. Paragraph 92 of the Appeals Guidance refers.
The Board will produce a written report and send two copies each to the Police Authority and the appellant and one to the Home Office. The report will include the Board’s decision signed by all the Board Members; reasons for the decision; details of the evidence produced by both parties; and a short record of the appeal proceedings. Where the Board decides in favour of the Police Authority, it must also report whether in the Board’s opinion the appeal was frivolous or vexatious.
Costs and Payment
AHS’s charges are set out at Annex D . They include a sliding scale of charges for appeals postponed, cancelled or adjourned without adequate notice of at least 10 working days where the Board considers that there are no exceptional reasons (paragraph 98 of the Appeals Guidance refers).
The charges are fixed for the first 2 years of the Contract and will increase in line with the Retail Prices Index for the third year. The level of charges will be reviewed prior to any possible extensions to the contract.
AHS’s charges will normally be paid by the Police Authority except where the Board determines that the appeal was frivolous or vexatious. When the Board decides in favour of the Police Authority and reports that in its opinion the appeal was frivolous or vexatious, it will invite comments from the parties within 14 days as to the award of costs to the Police Authority. The Authority can require the appellant to meet AHS’s costs either wholly or in part unless the Board decides, after taking account of any representations from either party, that there are exceptional reasons. Paragraph 96 of the Appeals Guidance refers.
Each party to the appeal will need to meet his or her own expenses of attending the hearing. If the appeal is successful, the Police Authority will refund to the appellant his or her personal expenses in attending the hearing where reasonably incurred.
AHS will send invoices direct to the Police Authority. In cases where the appellant pays some or all of the costs, the Police Authority will recover costs, normally by instalments (as under the current system).
With regard to the two targets referred to in paragraph 13 above, AHS’s charge will be reduced by 5% if it fails to meet one target and by 10% if it fails to meet both.
The only circumstances where AHS may claim re-imbursement of additional costs from the Police Authority are:-
where additional members are appointed to the Board;
where additional costs (which must be discussed with and agreed by the Police Authority in advance) have been incurred because a special appeal hearing has had to be arranged;
where the hearing has been postponed, cancelled or adjourned without adequate notice;
where AHS have incurred costs in obtaining additional medical documents.
If AHS and the Police Authority are unable to agree what additional costs have been incurred or will be incurred by AHS, or whether services have been provided within the agreed timescales, AHS will refer the matter to the Home Office for a decision.
25 The flowchart at Annex E shows the forms needed by Police Authorities and appellants for progressing appeals under the new system. They are:-
Appeal Form A Appellant’s Notice of Appeal
Appeal Form B Police Authority’s Appeal Notification
Appeal Form C Appellant’s Submission
Appeal Form D Police Authority’s Submission
Appeal Form E Submission of appellant’s medical documents.
These forms are being finalised in consultation with the PNB and will be issued by e-mail to the designated contact points within Forces / Police Authorities before the commencement of services on 10 November 2003. They will also be issued with the further HOC next month (see paragraph 32.) There will be space on the forms for the relevant Force to be inserted but otherwise they should not be customised.
- AHS will retain appeal case papers for 12 months after completion of the Board’s report and will then destroy them. During this period AHS will be responsible for dealing with Subject Access Requests under the Data Protection Act 1998.
Training and guidance for Board Members
There will be a Home Office-led Training Day for Chairs and Second Members on 11 November followed by an internal training day. Visits to Forces will also be arranged.
The Home Office’s guidance for Board Members will be available shortly on the Home Office’s Police Reform website at www.policereform.gov.uk
Monitoring and feedback
AHS will provide management information to the Home Office and will also provide information showing the extent to which it has met agreed Key Performance Indicators. Some of the information will be based on responses to Customer Satisfaction Questionnaires issued to the parties to the appeal by AHS.
The Home Office will carry out a review of the operation of the Boards 15-18 months after the commencement of services. AHS and Police Service representatives will participate in the review.
The Home Office will hold regular meetings with AHS and would be interested to receive feedback at any time on how the Boards are operating.
- A HOC will be issued in late November 2003 which will include:
- A separate HOC will be issued when the Regulations have been amended retrospectively. This HOC may also contain further guidance based on early feedback on the introduction of the appeal boards system.
The appeal forms should be sent to the AHS administrator and should be copied to any other recipients specified on the forms.Other correspondence and enquiries concerning appeal cases (including arrangements, progress, decision and payment) and all completed Customer Satisfaction Questionnaires should go to the AHS administrator except where notified otherwise. The contact details are:-
The Police Medical Appeal Board Administrator
Aon Health Solutions
2 Circus Place
Tel. 020 7638 3421
Fax. 020 7628 0487
Any feedback (other than completed Customer Satisfaction Questionnaires) on the operation of the Boards, and any enquiries on this Circular should go to the Home Office. The contact details are:-
Police Personnel Unit
5th Floor, West Wing
50 Queen Anne’s Gate
London SW1H 9AT
Tel. 020 7273 2814
Fax. 020 7273 2501
(address as above)
Tel. 020 7273 2541
Fax. 020 7273 2501
- Correspondence on policy issues concerning the Boards should also go to the Home Office. The contact details are:-
(address as above)
Tel. 020 7273 4120
Fax. 020 7273 2501
(address as above)
Tel. 020 7273 3107
Fax. 020 7273 2501
Head of Police Pensions and Retirement Policy Section