1. Providing advice to Teacher’s Pensions
Dr Noel McElearney December 2016

2. OH Assist Ltd Large Occupational Health (OH) provider.
In addition largest specialist Pension Medical advisors:
NHS Pension Scheme,
Teachers in England and Wales ,
The Scottish Public sector scheme,
Several employers in the LGPS,
as well as a variety of private clients including the BP and RBS group of schemes.
The Pension team provide advice in a quality managed environment on 8,000 cases
per year.

3. The OH Assist Pensions Team
Based mostly in Glasgow
Dedicated doctors and administrators.
Working in a fully managed quality system.
System description
Dedicated People (Employed)
With appropriate qualifications (Disability and Occupational Medicine)
Full training
Pension Standards
Quality and audit (IQAS and ISO) – looks at how a decision is made and how advice is written
Work in streams and with sets of cases.

4. Providing Pensions Advice is different.
It is advice, not a decision.
It must be complaint with what the Ombudsman expects in regards Pensions Legislation in general and the schemes rules in particular.
Must not be perverse
Must comply with the PO’s interpretations in general.
Sufficient information
Meaning of undefined words.
It may be disputed, twice under IDRP.
(OH advice is only disputed in a tribunal)

5. The OH Assist Pension standards (designed to Ombudsman proof advice)
All advice must comply with the OH Assist Pension standards. (approved by Clinical Governance Board)
These require the Pension Medical Adviser to set out :
Unique Identifiers for a member,
the criteria for the (subset) scheme,
the medical evidence used
the decision and
An QA compliant rationale for that decision.
For multi tier schemes an Omnibus approach is required.
The rationale must be
Written in plain language and accessible to a lay person.
OH Standards, comment is where schemes are multi tiered then an Omnibus approach is needed.

6. Working with TP
Member completes part A (includes a section asking how the illness affects them)
Employer completes Part B
Medical advisor completes the Medical Information Form at Part B.
Several pages designed to gather the relevant medical evidence.
These forms are sent to TP and uploaded to Hartlink system.
TP notify OH Assist that the latest batch of cases are uploaded, and OH Assist will allocate to a PMA.
The PMA writes the report live within the TP system.
We sometimes have to resort to contingency to keep delivering

7. The 2 tier criteria

8. Terms explained Appropriate medical treatment – means
appropriate for the impairing medical condition
reasonable for the member to undertake
impact is on capability to serve as a teacher and/or ability to carry out any other work
NICE guidelines define appropriate treatment for most cases.
Existing establishment or elsewhere means any school or place of education.
(Differs in Scotland)
Retirement Age – varies with section of the scheme
Impairment by 90% to carry out any work to NRA.
Evidence needs to be available at the date of application.

9. Working with the Department to deliver a quality Service
Monthly report -
Number of cases and outcomes
KPI Performance i.e. speed and audit outcome with which we deliver the case work
Report accept / reject rates
ICD codes
Doctor outcomes

10. October 2016 number of cases and outcomes accept /reject rates

11. ICD 12 month to October 2016

12. KPI Turnaround times Oct 2016