Change of Circumstances

The individual must notify Social Security Scotland of any change in circumstances that could possibly result in a change in the level of the individual’s entitlement or appropriate value of payment. This includes:

• if the individual is living in alternative accommodation
• a change in health condition or care needs
• a change in diagnosis meaning the individual is no longer considered to be terminally ill

If an individual is terminally ill, changes to the appropriate value of payment where the individual is in alternative accommodation follow the standard Adult Disability Payment rules for alternative accommodation.

However, payment continues for the enhanced daily living and mobility components after 28 days when the individual is in a hospice, is terminally ill and Social Security Scotland have been informed that the individual is terminally ill (ADP regs, reg. 29(1)).

A hospice is a palliative care institution that is not publicly funded and whose main function is to provide palliative care for people suffering from a progressive disease in the final stages. 1 ADP regs, reg. 29(2)

A hospice is a separate organisation to a hospital.

If an individual is receiving palliative care within a specialised ward or facility in a hospital or care home, the individual is considered to be in a publicly funded hospital or care home. Their award will be £0 rated on the 29th day.

Changes when an individual already entitled to ADP becomes terminally ill

If an individual already in receipt of ADP becomes terminally ill, a case manager should make a determination without application setting out the individual’s new level of entitlement.

This could happen in two ways:

• the individual informs Social Security Scotland that they have become terminally ill.
• a BASRiS form (or equivalent) is received by Social Security Scotland for an individual currently in receipt of ADP.

On receipt of a BASRiS form (or equivalent), or following verbal BASRiS confirmation with the RMP or RN, the individual’s award becomes subject to the special rules on terminal illness. Social Security Scotland will make a determination without application so that an individual under state pension age at the time of the clinical judgement receives the enhanced rate of the daily living component and the enhanced rate of the mobility component. There is no review date.

If we receive a BASRiS form for someone in receipt of Adult Disability Payment after the individual has reached state pension age but which is dated before the person reached state pension age then the limitations to any increase in the mobility component do not apply. (ADP regs, reg. 25(5)). This is because they became eligible for Adult Disability Payment under special rules on the date of the clinical judgement which was before they reached state pension age. They would be awarded the enhanced rate for both the daily living and mobility components.

If the individual is over state pension age when they inform us that they are terminally ill and when the clinical judgement is made then they receive the enhanced rate for the daily living component. The restrictions on the mobility component where the individual is over state pension age will apply. This means for their new award the rate of the mobility component cannot be increased.

The new level of entitlement begins from the earlier of:

• the date that the RMP or RN made the clinical judgement that the individual meets the terminal illness definition. Unless Social Security Scotland received this judgement on the phone this will be the date of clinical judgement on the BASRiS
• the date Social Security Scotland were notified by the individual that they were now terminally ill (ADP regs, reg. 26(4)(a)(b)).

Changes in award due to new information received

Social Security Scotland can make a determination without application if it becomes aware of a change of circumstances which would possibly result in an alteration to the rate of ADP payable, or cause entitlement to ADP to end.

This can affect one or more of the following:

• whether payment of assistance can continue
• which components of the assistance they receive
• at which rate of each component they receive the assistance.

Case managers might need to ask for further information to make the decision.

Examples of relevant changes in circumstances include:

• a change in prognosis  
• admission to publicly funded residential care
• change to immigration status
• official error
• moving from Scotland to another part of the UK.

For example, a terminally ill individual over 18 years admitted to publicly funded care home (not a hospice) would:

• stop being paid the daily living component after 28 days in residential care
• still be paid the mobility component.

An individual reports that there has been a change in their prognosis and they are no longer terminally ill. A case manager could request further information to establish the individual’s correct level of entitlement. Then a determination without application could be made setting out the individual’s new level of entitlement applying the normal rules.
[Read SRTI Ops Guidance]