As the Scottish government continues to expand its devolved benefits through its dedicated agency, Social Security Scotland, healthandcare.scot spoke with a social security practitioner.

From an NHS nurse to the practitioner role, Craig shares his experience and that the common thread found in each is delivering effective care with kindness.

“So I’d worked in the NHS for nearly 20 years and to be honest when I first saw this job – it was a little bit out of the blue,” Craig says.

“But I just really liked the philosophy and the massive shift from the previous way things were done with PIP [Personal Independence Payment].

“It certainly wouldn’t be something I’d consider before but I think there was quite a shift in building the organisation from the roots up, it felt like a good time to be part of that change.”

Since 2018, Social Security Scotland has delivered 13 new benefits to people across Scotland – with its fourteenth accepting applications now.

The organisation looks to improve the process, and held a public consultation on Adult Disability Payment this year – its most complex benefit, replacing PIP – aiming to deliver dignity, fairness and respect throughout Scotland’s benefits provision.

While Craig had no prior experience working with benefits, he emphasises that he's seen the importance of social security in people’s health and wellbeing.

He shares that “you become well aware” of the effects that poverty has on health working in healthcare, with the overrepresentation of poor health for people from more deprived areas.

What is a practitioner?

All practitioners have a background in health or social care to provide advice and support during the process of people’s applications.

The role spans from case work, supporting case managers with questions – from conditions or issues in applications they don’t understand – to ensure applications can be processed as smoothly as possible.

For Craig, this comes primarily from his time working as a nurse:

“I would use my medical knowledge to give a perspective, and looking at supporting information is valuable because that will help me create an impression of what’s going on in the client’s life.

“So that’s the bread-and-butter, day-to-day work to try and push things along to help case managers to get clients a decision.”

He explains that practitioners work across different projects “looking at the nuts and bolts” of improving service delivery, trying to work out any issues before new benefits launch.

Alongside ongoing projects to streamline the workflow, Craig is involved in high-priority work on Special Rules for Terminal Illness (SRTI).

In SRTI projects, Craig’s work involves engaging with GPs or other clinicians to try and achieve “very fast turnarounds” for people living with terminal illnesses.

As a practitioner, Craig says he likes having the constant aim of improving things for people and helping move their support forward, adding:

“Fundamentally,what attracted me to Social Security Scotland is the ethos of just treating people decently.”

In some case, practitioners will be involved directly with clients if they need and want a consultation as part of their application.

Craig explains this only happens periodically if they need more information once other avenues are exhausted, adding:

“We’re always upfront that consultation is very much a conversation and that’s something I’d say at the very start is ‘we’re just trying to get your story’.

“I want people to be relaxed, to make it as simple as possible to more fully answer the questions.”

Reflecting on his time working as a nurse,he says there are parallels between Social Security Scotland’s underpinning principles of dignity, fairness and respect and nursing’s code of conduct.

Central to working as a practitioner is good communication, and from communicating with patients and families as a nurse, Craig feels he now role applies these skills in a new way:

“This is just another extension of that to ensure people get the benefits they’re entitled to, to try and steer that process and helping case managers make decisions – it’s all about effective communication really.”

Building bridges

Reaching across services is slightly different working as a practitioner and Craig says the well-engrained avenues NHS staff have to other healthcare professionals are still being established.

While Social Security Scotland is trying to build these networks and bridges to simplify information-gathering, Craig adds that it takes time and often applicants will have the information themselves.

As a practitioner, he can help case managers ensure people’s needs are recognised in their applications and ensure any additional insight or clarity is gained.

He says that while work in his day-to-day can vary, the issue of supporting information arises frequently in his work as often people don’t know the range of sources for this:

“There are lots of different perspectives: a personal letter from a family member, a hospital letter, prescription lists... If you’ve got a hospital letter with detail about condition that is the absolute gold standard.

“If case managers have trouble making sense [of applications], especially if a patient's got a complex medical history or many comorbidities – practitioners can then use their experience to come in and look at what's there.

“It’s really about trying to let that person become a three-dimensional person – all of it helps to get a holistic picture of what’s going on.”

This information could be care plans, social work details, information from local authorities regarding housing adaptations or from employers about workplace adjustments and beyond.

Craig says while applications are designed to support the process of gathering key information, practitioners use their lived experience in health or care to fill in any blanks.

In some instances, Craig says, practitioners’ prior years of experience mean they can better understand what small references to a daily experience might indicate.

Having “walked a mile in their shoes in some regards” and met, spoken with, been there with patients throughout their previous roles, he says:

“It can be easier for us than case managers to think ‘this person’s got X going on’ and my experience of X is that they could have Y problems – and you’re pulling all the narrative threads together.

“That helps to gel in the case managers’ minds exactly where they want to go and speeds up the process.

“Ultimately, the more supporting information, the quicker we can draw conclusions and get the whole picture.”

Quietly confident

With applications open for the Carers’ Support Payment to offer more support to the 800,000 unpaid carers facing ‘devastating’ financial hardship across Scotland, a shift in workload is expected.

Applications for the new Scottish benefit are throughout November for adults in Perth and Kinross, Dundee City and Na h-Eileanan an Iar ahead of a phased national rollout next year.

Craig says awareness-raising and ensuring access social security entitlements is vital to their work and there are many experienced case managers and practitioners to deliver this:

“We have quite a few practitioners and we certainly have the capacity to deal with an increased workload.

“We’ve now got a very experienced bunch – I feel quietly confident it’ll go okay. The experience of the case managers and practitioners is invaluable to this.”

He adds that Social Security Scotland centres around kindness, both internally between staff and externally with clients – which he hopes to see felt by people in each new benefit rollout.

Read more: Independent Living Fund to reopen next year; Economic change key to Scotland's health inequalities; Holyrood scrutinises SDS 10 years on

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