Part 5: Preparing claimants for transition to other public organisations

Accident Compensation Corporation case management.

In our 2014 report, we observed that case managers did not routinely work with other public organisations to prepare claimants to move from ACC to another public organisation for support, particularly the Ministry of Social Development.

In our 2014 report, we recommended that ACC:

more actively manage the transfer of clients between it and other public entities to reduce the potential for people to miss out on services they are entitled to and to ensure that people are appropriately prepared for transfer to another public entity.

In this Part, we discuss ACC's response to this recommendation.

Summary of findings

Many rehabilitated people will not be able to return to their previous working and personal lives. People transferring from the care of ACC to another public organisation face uncertainty and often feel anxiety about the change. This is particularly true for people who will receive income and support that is lower than before their injury, including those transferring to the support of the Ministry of Social Development or those needing to seek new employment.

We did not see the progress from our 2014 audit that we expected. Overall, we still could not see a systematic approach to plan for, inform, and prepare the person transferring to another public organisation for support.

In our view, when planning the claimant's pathway, ACC needs to consider the likelihood of the claimant eventually needing the support of another public organisation. Where this is likely, there needs to be close co-ordination at the outset with those other public organisations or providers. This co-ordination needs to be sustained all the way through the claimant's journey. This will lead to a more seamless move for the claimant.

ACC told us that it expects its case managers to have meaningful discussions with claimants preparing to move to another public organisation for support. ACC also told us that it expects its case managers to work with the public organisation that the claimant is transferring to.

However, it was unclear to us how ACC communicates these expectations to its case managers. The framework for quality assurance we describe in paragraphs 3.34-3.42 does not specifically set out those expectations to guide case managers to plan for and manage claimants' transitions.

We encourage ACC to ensure that all guidance about transitions between public organisations sets out clear expectations of how claimants should be transferred and how case managers are to manage this.

ACC funds providers to work directly with claimants who have sensitive claims to help them prepare for transition directly from the care of ACC to other public organisations, or to connect the claimant with those organisations that can best meet their needs. However, we did not see how ACC assessed the effectiveness of this co-ordination.

Communicating expectations

ACC told us it expects that the initial conversations case managers have with new NGCM claimants (called "Welcome Conversations") and subsequent "check-ins" should be the places where a need for the support of another public organisation might be identified.

ACC also expects case managers to ensure that the public organisation the claimant is transferring to understands their needs.

ACC provided us with a process document with basic instructions on the options that case managers can discuss with claimants to practically assist them when transferring to the support of Work and Income.

We reviewed this document against what we found in 2014. In 2014, we found some case managers provided support through helping to arrange budget advice. We also said:

Case managers refer people who are able to return to work to Work and Income and, with the person's consent, provide information on suitable work choices to Work and Income. There is a form for this purpose. It is not clear to us to what extent that form is used. We did not see this form used in any of the files we reviewed.

The process document we were provided with reflects the same situation that we reported in 2014. We are unable to see from this document how ACC communicates specific expectations to plan for and prepare claimants for the move to Work and Income.

ACC also provided us with two other process documents that had some detail about referring claimants to other public organisations to fulfil specific needs in certain circumstances, such as residential care, and to veterans and their families with entitlements needing other support.

These specific process documents are more comprehensive than the Work and Income process document. We encourage ACC to review and enhance the rest of the guidance it provides for this particular transition, to achieve the same quality.

ACC told us that it will review and strengthen the relevant guidance it provides to case managers and more explicitly communicate its expectations.

How ACC's approach to quality assurance helps it to know whether its expectations are being met

The Quality and Performance framework includes some guiding principles that ACC uses to communicate its expectations of case managers for preparing claimants for transition to the support of another public organisation. The two most relevant guiding principles are that staff:

  • focus on claimant well-being; and
  • understand claimants' needs.

As discussed in Part 3, the CXQ and Quality and Performance Framework enables team leaders to review case manager engagements. For example, team leaders can directly monitor conversations by listening in. ACC considers that this helps it understand the quality of the conversations and identify any further development needs case managers might have.

However, it is still unclear to us how ACC gets assurance that specific conversations about transition are always held when they need to be held and with the quality it expects.

We encourage ACC to think about whether it needs to set more specific expectations with case managers and whether it needs to carry out targeted monitoring.

Seeking feedback from claimants transferring to another public organisation

Although ACC collects feedback on much of its case management process, we did not see evidence that it collects feedback just before and when claimants leave ACC. Getting this feedback while ACC is still in a position to address any concerns would help case managers to co-ordinate a more seamless transition. It would also enable ACC to assess whether case managers are meeting its expectations to support a seamless transition.

One option might be an exit interview or survey carried out by an independent party. This could give people transferring to another public organisation the chance to tell ACC whether they felt case managers had done all they could to prepare them for the move.

ACC told us that it will consider how Heartbeat surveys could get feedback from claimants transferring to other public organisations. In our view, there are also wider opportunities that ACC could explore to actively seek feedback from these claimants about their experiences of transition.

Claimants with sensitive claims needing the support of other public organisations

ACC funds providers to prepare claimants with sensitive claims for transition from the care of ACC to other public organisations, or to connect the claimant with organisations that can best meet their needs. This funding is available in situations where other organisations provide support that ACC cannot or when they provide support alongside ACC.

It was not clear to us how ACC knows how well these transitions are working in practice. We did not see how ACC seeks and assesses feedback from people receiving this support. This type of feedback could help ACC understand how well this support is meeting claimants' needs.

In our view, ACC could do more to gather the perspectives of people with sensitive claims to fully understand their experience with the providers that ACC provides funding to.

Sensitive claims will be included in Heartbeat surveys from the end of September 2020. ACC told us that it will now also look at whether it can include claimants' perceptions of how well it co-ordinates with other public organisations in those surveys.