Part 2g - Payment of people involved in shaping health and social care services

Payment of people involved in shaping health and social care services

People who give their time and expertise should be paid for it. You will need to develop guidelines for paying them.

Participating should not put people at a financial disadvantage. It is good practice to pay 'out of pocket' expenses such as travel and carer costs. For use of a car the Inland revenue set expenses per mile, depending on engine size and mileage, that are not liable to tax.

Make it easy for people to get their expenses - have cash available to pay on the day, and pay automatically, using a receipt rather than a claim form. many people can only participate if you actually provide transport, childcare or respite care, or pay money for fares in advance. You can increase the range of people you involve in this way.

But valuing people's experience and expertise means paying them. for example,

Vouchers for small sums are sometimes given in recognition of the cost of completing surveys or interviews, and may help to engage some 'harder to reach' groups.
A payment to club funds or a charity may be more appropriate than individual payments where groups are involved: it demonstrates worth while acknowledging altruism.
Service users acting as consultants or providing staff training, for example, should be paid in line with the rate for a professional undertaking the same work.
Many lay members on committees sit alongside paid non-executive members. What message does this give about the value of their contribution? Good practice guidelines drawn from the Association of Directors of Social Services Survey suggest that co-opted members of panels and committees should receive the same payment or allowances as other members ¹ .

Definition of unpaid work

Unpaid work is done voluntarily for which there is no payment in cash or kind. Only expenses actually incurred can be paid.

The law about what constitutes a contract between an organisation and people doing unpaid work, and what payments are allowable, is at present unclear. The voluntary sector is well aware of the position and could share its experience

The position of people dependent on benefits

An outline of the position is given here, but benefit rules are complex, and the Benefits Agency has discretion in the way that they are applied, so seek expert and up-to-date advice.

People who use health and social care services will often be dependent on benefits. You will need to make them aware of their position with regard to Benefit Agency and Employment Service rules governing earnings and availability for work. This will allow them to make an informed decision about whether/how to accept payments, and giving their time.

Benefits that can be affected include:

Income Support
Job Seekers Allowance
Incapacity Benefit
Housing Benefit
Council Tax Benefit

Information to participants should include:

A clear outline of the rules governing earnings for people receiving benefits.
That it is the claimant's duty to declare earnings for benefit and tax purposes.
That if they are requested to do so, statutory agencies have a duty to declare any payments made.
That participants should seek specialist advice from welfare rights services or the Citizens Advice Bureau if their benefit claim could be jeopardised.
Payment options and the way payments are made.

Distressing problems with benefits can also be avoided by providing a clear statement for the Benefits Agency, as part of a 'contract' with the service user. This should state:

That it is recognised that the individual is available for work, and could be available at short notice.
That there is a contract number where the Employment Service can leave a message while the individual is engaged in 'user involvement' activities.
The type of payment being made.
The non-financial benefits of the activity, for example, gaining skills, getting a reference.

Expenses

Payments made to people on means-tested benefits to cover expenses are not regarded as income.

"Your Income Support will not be affected as long as you do not receive any pay other than to pay for expenses like fares or special clothing you need for the voluntary work." DSS

Take care if paying a flat or daily rate of expenses, as the Benefits Agency has the discretion to decide what is 'reasonable', and whether this could be classed as paid work. Regular sessional fees, a flat rate payment to cover expenses and subsistence, or honoraria, could be regarded as payment for work, and such payments would be taxable.

The situation regarding payments in kind is contradictory. Guidance states that they are ignored for benefit purposes, but also that they may be regarded as income.

"You must also tell us if you are paid in any way. This includes things that are sometimes called payment in kind. This could be something like meal vouchers." DSS

Payments to those on benefits

Participants receiving means tested benefits can do paid work for up to 16 hours a week. They are required to declare earnings, and after a small 'earnings disregard', benefit is reduced pound for pound. Currently (October 2000) those who receive a lone parent, carers or higher pensioner premium as part of their Income Support, and those who receive a disability, or severe disability premium for themselves or their partner, can keep Ł15 of any earnings before they lose benefit. Single people on Income Support or income based Job Seekers Allowance keep Ł5 of any earnings, while those who claim as a couple keep Ł10.

Making a weekly payment up to the relevant disregard limit over a period of time could avoid loss of income from benefits. Care is needed if earnings would result in the loss of Income Support (as a 'top up' to Incapacity Benefit, for example). An individual could be worse off through the loss of benefits such as free school meals to which Income Support is the 'passport benefit'.

People working for more than 16 hours a week have to 'sign off' while they are earning. If there is a break in claim of more than 12 weeks they will not be paid for the first three days of a new claim, and may have to restart the qualifying period for mortgage payments. Those working less than 16 hours can continue to 'sign on' for national insurance credits even if no benefit is payable.
People who have received sickness benefits for more than 6 months who find themselves unable to continue in a new job within a 52 week period, can return to their previous benefit without penalty.

Incapacity Benefit

This benefit is paid to people who are deemed to be incapable of work because of sickness or disability. People on Incapacity Benefit must be extremely careful not to invalidate their claim when taking on any work. Voluntary work (defined by the Department of Social Security as "work other than for a close relative for which a person only receives reasonable expenses") is exempt, as is some work, if it is undertaken on the advice of a doctor to:

Improve, or to prevent or delay deterioration in, the disease or bodily or mental disablement (this is called 'therapeutic work')
Form part of a treatment programme under medical supervision whilst the claimant is a hospital in-patient or out-patient
Or, is done while attending a centre that provides sheltered work

There is an earnings limit, currently Ł58.80 a week, and work must not exceed 16 hours a week "on average" (DSS).

To avoid problems, claimants should always obtain a letter from their doctor stating that the doctor suggests or advises therapeutic work, and gain Benefits Agency approval before undertaking any activity that might be perceived as paid or unpaid work.

Notional Payments

If a claimant is deemed to be providing a service for free, or at less than the local going rate, then they could be regarded as having 'notional earnings' and their benefit reduced accordingly, even though they are not actually paid.

"If it is unreasonable [for an organisation] not to pay you, we will reduce your Income Support by an amount you could expect to be paid for the work you are doing, even though you are not being paid." DSS

This rule could be applied if an organisation normally employs someone to do the same kind of tasks the service user does. However, the Employment Service may accept that it is reasonable for someone to provide a service free of charge if they are gaining a non-monetary benefit, such as improving their confidence and self-esteem, or gaining skills that will improve their job prospects.

Giving time

"There are no limitations on the number of hours a jobseeker may volunteer provided they remain available for paid employment and actively seek it." Employment Service Guidelines. There are limits for people receiving Incapacity Benefit. (See Incapacity Benefit)

People signing on as unemployed must show that they are 'actively seeking employment', and be available to work 40 hours a week, except in the following circumstances:

Fewer hours are reasonable because of the individual's mental or physical health
People with caring responsibilities must be available for at least 16 hours
Restricting the number of hours available doesn't reduce prospects of employment

References

Jones R 1995 Co-opting carers and users ADSS News April p18-19

Prepared from:

Dawson J 1999 Volunteers and Welfare Benefits - Guidance Notes The National Centre for Volunteering 4^th Edition

McHarron A & Nettle M 1999 Guidance Paper 1: Payments to Service Users West Midlands Users in Partnership NHS Executive West Midlands/ West Midlands Mind

Information from the DSS www.dss.gov.uk , Citizens Advice Bureau www.nacab.org.uk & National Centre for Volunteering www.volunteering.org.uk