Referee’s Referee’s commentscomments

Age ProfileAge Profile

2 peaks:2 peaks:

• 20 - 29y – recruiting age 20 - 29y – recruiting age (asthma, (asthma, eyesight eyesight • 50 – 59y – older Age group (IHD, 50 – 59y – older Age group (IHD, OA OA etc)etc)

Medical categoriesMedical categories

• Cardiovascular 30.8%Cardiovascular 30.8%

• Endocrine 14.2% Endocrine 14.2%

• Sensory 12.9%Sensory 12.9%

Significance!

AD’s decision vs. MR’s decision

AD’s decision Number Percentage MR’s decision Number Percentage

Fit 0 0.0 Fit 66 14.2

Fit with restrictions 111 23.9 Fit with restrictions

252 54.2

Temporarily unfit 86 18.5 Temporarily unfit 62 13.3

Permanently unfit 268 57.6 Permanently unfit 85 18.3

Total 465 100.0 Total 465 100.0

AD’s decision vs. MR’s AD’s decision vs. MR’s decisiondecision

• Most common AD decision – Category 4Most common AD decision – Category 4

• Most common MR decision – Category 2Most common MR decision – Category 2

• Most common reasons for grading Most common reasons for grading change- cardiovascular, endocrine, change- cardiovascular, endocrine, sensorysensory

Referee’s workloadReferee’s workload

• Large variation in MR workload.Large variation in MR workload.

• 4 referees saw 58% of the referrals.4 referees saw 58% of the referrals.

• 1 referee saw more then 20% of the 1 referee saw more then 20% of the referrals.referrals.

ReassuranceReassurance

•No significant association No significant association between MR’s decision and between MR’s decision and Referee code.Referee code.

Interesting pointsInteresting points

• The 3 MRs with most dove-like trait The 3 MRs with most dove-like trait were the top 3 in terms of workload!were the top 3 in terms of workload!

• Most appellants benefited from Most appellants benefited from appeal –only 2% were downgraded.appeal –only 2% were downgraded.

ConclusionsConclusions

• Most findings were as expected.Most findings were as expected.

• The commonest reasons for appeal have The commonest reasons for appeal have been addressed in the new guidelines.been addressed in the new guidelines.

• High variance between ADs and MRs by High variance between ADs and MRs by medical category may indicate a need for medical category may indicate a need for revision of the standards.revision of the standards.

RecommendationsRecommendations

• Consider MR workload review.Consider MR workload review.

• Monitor variance between ADs and Monitor variance between ADs and MRs by medical category to MRs by medical category to determine effectiveness of determine effectiveness of standards.standards.