Recommendations from the clinical review

An extract from the report of the Sensitive Claims Pathway Review Panel

Recommendation 1 That ACC ensures that all aspects of their Pathway(s) and associated claims processes are in line with the Massey Guidelines by seeing that they:
• are developed and implemented in ways that recognise and protect client safety and the importance of the therapeutic relationship;
• take a client focus; and
• recognise the special needs of particular groups including children, adolescents, people with mental illness, people with intellectual disabilities, Māori, and Pacific peoples. (page 14)

Recommendation 2 That future changes to the Pathway and associated processes are planned, managed and implemented with meaningful engagement and consultation with the sector and relevant government agencies. (page 18)

Recommendation 3 That, as a priority, ACC commence work with relevant sector experts to agree additional standardised systems for determining mental injury - including ones that would be appropriate for children and for Māori - and discuss how they should be used to confirm that a claimant has a mental injury for ACC when making cover decisions under its legislation. (page 24)

Recommendation 4 That, in determining whether a mental injury has been caused by a Schedule 3 event, the test should be that the sexual abuse was a substantial or a material cause of the injury. (page 24)

Recommendation 5 That all ACC communications with survivors of sexual abuse need to be reviewed as a matter of urgency taking a client perspective and using survivor and expert provider assistance in the process. (page 34)

Recommendation 6 That ACC establish an appropriately constituted working party involving professional groups to examine credentialing or other means of ensuring that the workforce for treatment and assessment, including the new therapeutic assessment and recovery support process, is fit for purpose and meeting quality standards. (page 38)

Recommendation 7 That, in order to ensure processes around the Pathway(s) are of good quality, safe and effective for ACC, clients, and providers, ACC work with the sector, survivor representatives and relevant government agencies to develop and implement a comprehensive quality framework including strengthened processes for:
• provider approval and auditing
• appropriate service standards and monitoring
• workforce training and development
• ongoing professional development, and
• continuous service improvement. (page 38)

Recommendation 8 That ACC move to improve access for survivors by introducing 16 hours of immediate therapeutic assessment and recovery support from a registered ACC treatment provider for new claimants, those currently under consideration under the Pathway, those who have had a claim declined and those who have chosen to withdraw their claim under the Pathway. (page 45)

Recommendation 9 That these initial changes are planned, managed and implemented quickly and effectively - giving priority to claims for children - with input and/or oversight from relevant sector experts and government agencies. (page 45)

Recommendation 10 That ACC work with sector representatives to evolve the Pathway(s) based on the Massey Guideline principles and the proposals and principles in section 9 of this report giving particular attention to the needs of children and adolescents. The amended Pathway(s) must clarify how cover for treatment according to need will be available to those needing more than the initial 16 sessions recognising that this will be particularly important for adult survivors of child sexual abuse. (page 45)

Recommendation 11 That a proportion of claimants may be required to undergo an assessment for cover from an assessor who is not their treatment provider before a decision about cover is taken or to review ongoing therapy. These assessors should themselves be experts who have worked with sexual abuse victims and, wherever possible and desired by the client, the client’s usual treatment provider should also be involved in the formal assessment process and in determining appropriate treatment goals and plans. (page 45)

Recommendation 12 That ACC ensure that any assessment for cover processes for all claims requiring a treatment decision have occurred and a decision has been made within 6 weeks of being notified that a decision on cover will be needed. If this is not possible for any reason outside the client’s control then further two weekly therapeutic assessment and recovery support sessions should continue to be funded until the assessment is completed and a decision on further cover is taken. The assessment and cover decision must be taken at the latest within nine months of the claim being lodged - and preferably sooner. (page 45)

Recommendation 13 That ACC provide mechanisms for involving families/whānau in therapy especially for children and adolescents. (page 45)

Recommendation 14 That a process be established to independently monitor the development and implementation of actions recommended in this report. (page 45)

Read the full report here.