A fair decision making process impacts people’s sense of how they are dealt with, and it affects how they deal with the decision. 

A  poor decision making process can lead to much angst.  

The Work Capability Assessment was introduced in the UK in 2008, to assess whether 1.6 million people should continue to receive welfare benefits. In a subsequent review of the Work Capability Assessment scheme it was noted that 40% of people found fit for work appealed that decision, and 40% of those who appealed had the original decision reversed.

Along with the enormous cost of appeals, there was a significant public reaction against the assessments and a loss of trust. Charities devoted to the care of people with a disability reacted against the assessments, and an independent review of the assessment process labelled it impersonal and mechanistic.

People who were assessed say the questions were difficult to answer and many were not relevant to their medical condition. A significant percentage of people said they did not feel that they had been listened to through the process, or that key information from their treating practitioners had been taken into account.

Procedural justice experienced by people subject to the assessment was low, resulting in a large number of negative reactions and a high proportion of disputes about the decision. The financial cost of dealing with the appeals was high, public reaction was negative, and public policy lost credibility. AND the large group of people who have suffered as a result of the assessment are frustrated and angry.

In the first of this series we discussed how a fair system goes a long way towards negating the impact of an unfavourable outcome, without eliminating it entirely.

How does one create a decision-making process that's perceived to be fair and reasonable by the person about whom the decision is being made?

A number of elements lead to decision-making systems lead to them being judged as fair.

These include:

• Ensuring the process and decision-making is consistent.
• MAKING the process follow reasonable moral and ethical standards. Ensuring the process is not corrupt or biased by gender or race. Eradicating conflicts of interest from the decision making personnel.
• Information used to make the decision must be accurate. If a questionnaire is used, it needs to reasonably reflect the person's situation. If the decision is about somebody's level of pay, ensure feedback provided from others is trusted and reliable.
• Giving participants the opportunity to correct information. For example, if the individual considers some of the information taken into account is inaccurate, there must be an opportunity to correct it.
• Ensuring that all relevant information is used - if a report from the person’s treating doctor is needed, the system’s procedures must ensure it is obtained. 
• The interests of all parties must be represented. For example, if there is a dispute between two people at a workplace being dealt with by mediation, both parties must feel that their views have been heard and that they are equally represented.
• Explaining the process well. This includes information being made available before a decision is made, the details of what is taken into account, who makes the decision, when and how the outcome will be conveyed, and how the person can  have the decision reviewed.
• Treating participants with dignity and respect. In the UK example cited above, a number of people said that there was no eye contact between them and the health practitioner when they attended for a medical review appointment.

Good systems have interpersonal communication styles that acknowledge the person, and result in the person sensing they are an important part of the system.

How organisations can improve procedural fairness.

The organisation needs to believe that procedural fairness is important. If it does not recognise the importance of procedural fairness on outcomes, it's unlikely the organisation will spend the time and energy to improve how the decision-making process is perceived.

There are three broad approaches to improvement:

1. Training staff:
   
   It's hard conveying bad news to a person. Nevertheless, there are ways this can be done empathically: a smile in the voice, listening for the impact on the person, talking through any negatives, and helping the person understand the process through which the decision has been made.
2. Allowing time for adequate communication:
   
   It takes time to talk to people, it takes time to communicate with people before a decision is made, it takes time to let them know about how decisions are made, and it takes sensitivity to convey the decision.
   
   If the decision maker or those conveying information don't have time, it's difficult to leave the individual impacted by the decision with a sense they are respected and have been treated fairly. Organisations need to ensure that appropriate time is available for communication.
   
   
3. Setting up information, standard letters and documents that make sense to the end-user:
   
   Ensuring relevant information is available on the web, or is provided to the individual in hard copy can also set up a sense of fairness from the outset.
   
   Organisations may be concerned that the decision is conveyed in a legally sound manner. Unfortunately this can mean that the information is legalistically framed, making it difficult for the impacted individual to understand what is being said.
   
   Time and thought on a relevant template, employing a plain language writer, and discussing ways relevant documents can be transformed from legalese into a readable document are important.

Procedural fairness involves treating people in the way you would wish to be treated in the same circumstances.

We've all dealt with situations where we've got the short end of the stick. To ensure you don’t inflict similar experiences on others consider providing:

• Assistance in the early stages of a decision-making process.
• An explanation about the process.
• Information on the timeframe for decision-making.
• Return all calls.
• Complete actions within stated timeframes.
• Consult on who makes the decision.
• Help if there is an issue.
• Allow the person to be important in the process.

All of these make the difference between a positive and negative outcome.

In part three, we explore decision-making justice and workers comp...