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Exception: Review periods under 24 months
In exceptional circumstances, case managers can set review periods of less than 24 months. This should only be done when it is clear from the information available on the individual’s circumstances that their condition is likely to change significantly before the 24-months mark. Case managers must make sure that the individual is likely to meet the forwards test.
Case managers should consider the available information on the individual to:
- understand the individual’s prognosis
- decide if a review period under 24 months is appropriate.
Setting a review period under 24 months could be appropriate due to one of the following having a significant impact on the individual’s needs:
- scheduled surgery planned beyond the longest possible time period for delaying a review
- scheduled, staged corrective surgery
- the individual recently starting new treatment likely to have a significant impact on their needs
- the individual soon completing treatment likely to have a significant impact on their needs once recovered it being difficult or impossible to anticipate how the individual’s needs will develop between 26 weeks and 24 months from now. This could be due to a degenerative condition where the individual’s needs are expected to increase but the pace of change is unclear.
- the individual soon beginning a new phase in their life likely to have a significant impact on their needs, for example moving into adapted accommodation.
- This list is not exhaustive.
Setting a review period of under 24 months may be appropriate if it is impossible to anticipate how the individual’s needs will develop beyond that time.
Case managers must make sure that this lack of clarity is not simply due to any of the following:
- their lack of knowledge of the individual’s condition
- gaps in the application, review form or in supporting information that they have not yet explored with a practitioner or the individual
- their lack of general confidence regarding setting review periods. In this case, case managers must request a case discussion with a practitioner to discuss what an appropriate review period would be.
Example: an individual’s award of ADP will be reviewed in 12 months
Oakley is 21 years old. In their application, they explain that they were diagnosed with anorexia nervosa at age 17 and have been under the care of specialist psychology and dietetics services. Oakley states that they are making positive progress and has been slowly gaining weight, but that they continue to require prompting with preparing food and taking nutrition. The impact of Oakley’s condition means that they are experiencing fatigue and lack of energy because of limited nutrition.
Both the application form and the supporting information suggest that input from physiotherapy and occupational therapy has been focused on helping Oakley to pace themselves and manage their fatigue.
Based on the information available, the case manager establishes that Oakley’s needs are highly likely to change in the near future. Setting a longer review period therefore would not be appropriate.
To establish the point in time when Oakley’s needs are likely to have changed, the case manager reviews the information provided by Oakley again. The supporting information obtained from dietetics indicates Oakley is making good progress and will likely be discharged from the service in the next six months. The case manager expects that it will take some time afterwards for Oakley’s needs to stabilise. They request a case discussion to get advice on how long this period is expected to be. The practitioner explains that, based on Oakley’s current progress it would be reasonable to expect their situation will have stabilised 6 months after they are discharged. [. Based on the case discussion, the case manager determines that it would be appropriate to review Oakley’s award in 12 months, as it is important to see if Oakley can maintain a stable weight and begin to manage these activities without prompting.
Example: An individual’s award of ADP will be reviewed in 18 months
David is 54 years old and 8 months ago he had a stroke. He was admitted to hospital for 10 days where he received clot-busting medication. David has been left with right side weakness to his arm and leg. David has been attending physiotherapy and has been making progress with strengthening and moving his right arm and mobilising. In his application for ADP, he explains that,
- after discharge from hospital, he has been continuing to see the physiotherapist once weekly for strengthening exercises to the right arm and leg
- there has been an improvement.
In a letter submitted by David as confirmation from a professional, the consultant has advised that with the progress David is making in physiotherapy, there should be significant improvement in the next 12 to 18 months. The case manager determines that due to the expected improvement in David’s condition, a review in 18 months would be appropriate.