Considering the value of supporting information
Useful supporting information will help you understand an individual’s needs so you can make a determination about their entitlement to assistance.
You will not need additional supporting information for every application and the type of supporting information available will differ from client to client. This will depend on the individual’s condition, needs and circumstances.
You should not expect:
- to be able to get the same pieces of supporting information from every individual
- that the value of that information will be the same in every case
Additionally, it is not possible to be prescriptive about the minimum requirements for a piece of supporting information to be considered valuable, because it will depend on the specific circumstances.
You should consider the factors outlined in this section when deciding:
- how valuable a piece of supporting information is
- whether more information is needed to make a robust decision i.e. if the information you have is not valuable
Factors to consider
When deciding whether a piece of supporting information is valuable you should consider:
- who it’s from
- the period of time it relates to
- the content
When considering a piece of supporting information you should:
- Consider all the information you have within context.
- Use other decision-making tools if you are unsure how to interpret it, e.g. a case discussion
Who the information is from
You should consider if the source:
- knows the individual and understands the impact their condition or disability has on their life
- offers insight into the individual’s condition or disability as a result of their role in the individual’s life
- is involved in the individual’s treatment or care regularly
You should be satisfied that the provider of information can be reasonably expected to have an insight into the individual’s life. There is no definitive list of the nature of the way in which someone providing supporting information should know the individual.
If they are providing supporting information it is reasonable to assume that they have the insight required to provide it, unless you have reason to think otherwise.
For example, it is reasonable to assume that a young person’s college tutor has a good level of understanding about the individual’s life. But if you know that the individual has been out of college for 18 months, you’re likely to view the information as less valuable. This is because the individual’s needs may have changed from when the teacher last saw the individual 18 months ago.
The reason why the supporting information in this example may be less valuable is because how regularly someone sees the individual may impact how valuable a piece of supporting information is. This does not mean that the source has to see the individual or the impacts of their condition at a given regularity to be considered valuable. Rather that you should consider whether it is more likely than not that the source of supporting information will be able to offer insights into the individual’s condition or disability based on how often they see the individual.
This will differ from case to case. It should also be considered in regards to whether the individual’s needs are likely to have changed in the time since the source saw them, or if their condition remains fairly consistent.
There may alternatively be details in the information itself which de-value the perspective of the person providing it. For example it may be clear that the person has simply observed from afar, rather than being directly involved in the individual’s life.
There are specific details required from people providing supporting information as a professional. You should use the guidance on types of professionals and the Gathering supporting information chapter to help you identify a professional.
The period of time the information relates to
How up-to-date a piece of supporting information needs to be in order to be considered valuable will differ from case to case.
This applies to both the confirmation from a professional and additional supporting information.
The key consideration is whether or not the information is relevant to the period the application or award review relates to. That does not necessarily mean the information needs to be recent. However, you must be able to make a reasonable assumption that it is relevant to the circumstances existing at the time the application or award review relates to.
The two main factors influencing how close in time the supporting information needs to be to the application are
- the nature of the individual’s disability or health condition
- the individual’s age.
Individuals who have a disability or condition which is likely to remain consistent in the way it impacts them may have supporting information which is still relevant after many years
Only if an individual’s condition is likely to have changed in a way that may impact their needs since the date of the supporting information might there be a reason to obtain more recent information. That may be especially the case for individuals who have become newly disabled following a significant illness or injury, such as having had a stroke or having a limb amputated following a major trauma. In these instances it’s probable that the individual’s needs in the year immediately after the event might change to a greater or lesser extent after that point.
The age of the individual is also relevant to how current the supporting information needs to be. For conditions which require careful management and strict adherence to treatment regimes, mental health conditions, diabetes or epilepsy for example, it’s likely that individual’s may need more support as young adults than they will a few years later. In which case, information from when an individual was 15 may be relevant to their needs at 18, but may be less valuable when they are 22.
For older individuals, it’s a reasonable assumption that once an individual has reached around retirement age, it’s unlikely that the impact a condition has on their needs will become any less. So while you might require more recent supporting information for a 27 year old individual who had a serious pelvis fracture at 20, it’s likely that the needs of an individual who had the same injury at 57 will be the same at 70.
When deciding whether dated information is still relevant, you should consider the individual’s current needs and decide whether it is more likely than not that their needs have changed since the date of their supporting information
It is the date of the supporting information that is being explored here, not the content of the supporting information.
You may conclude that that supporting information was dated from a time relevant to the application or review but the information it provides is inconsistent with other information you have gathered, In this case, the supporting information is relevant but there is an inconsistency.
You should also ensure that the supporting information supports the backwards and forwards test. Supporting information meets the backwards test if it relates to needs the individual has had for at least 13 weeks before the date of application and you can conclude that it is more likely than not that the individual has had the stated condition or needs for all days of those 13 weeks.
If you’re unsure if the information is current enough to help you, you should other decision making tools, such as medical guidance or requesting a case discussion.
Example: when confirmation from a professional more than a few years old may still be valuable
An individual with a diagnosis of a long-term chronic disability or condition, such as osteoporosis, may have supporting information from ten years ago that acts as a confirmation from a professional, and can also be used to establish needs.
The case manager may use this supporting information to support them in making a determination where it is clear that there is likely to be no change in that individual’s needs in the period since the supporting information was produced.
Example: when supporting information more than a few years old may not still be valuable
A case manager may receive supporting information from a professional to establish needs about an individual who has a diagnosis of a physical health condition, such as relapsing remitting multiple sclerosis, from three years ago.
However, as the particular condition can come and go in impact, this piece of supporting information may not be useful in coming to a decision on an individual’s level of entitlement to ADP.
This is because the supporting information may no longer reflect the individual’s current needs. In this case, further information about the individual’s current needs might be sought.
The information could however be used as confirmation from a professional because although the specific way in which the individual is impacted may have changed, the fact that they have a diagnosis at all will not have.
Telling the client that they might need to provide new supporting information at the next review within their review period justification
When justifying your review period decision, you might identify that the supporting information currently provided will be out of date and not of the same value at the time the individual’s next review is set for. In these circumstances, it may be appropriate to set out to the individual within their review period justification that they might need to provide new supporting information at their next review.
The aim here is not to 'verify' what the individual might tell us in their review form and you should always consider whether the existing supporting information will continue to be relevant by the time of the individual’s next review.
This should always be approached from a position of:
- supporting the individual to engage with their scheduled review
- ensuring the next case manager is more likely to have up front the information they need from the individual to make a robust review decision.
There will be times when asking for new supporting information would not be appropriate, as the information provided will continue to remain relevant or up to date. In these circumstances, the next case manager would use the appropriate decision making tools if needed to establish the individual's new level of need at review.
Example 1: The case manager explains an individual will likely need to provide new supporting information at their next review
John is 30 years old and has depression. The case manager familiarised themselves with John’s application and supporting information. John explains that he had recently received a distress brief intervention and is engaging with his GP and wider support services.
A Distress Brief Intervention is a non-clinical intervention. Firstly, trained front-line staff (such as a police officer, paramedic or A&E staff) help ease an individual’s distress, and where appropriate offers a referral to trained third sector staff who contact the individual within 24 hours. They then provide community-based support, distress management planning and further signposting.
John provides a prescription list as confirmation from a professional with his application, confirming he has been prescribed 20 mg of the antidepressant Fluoxetine for the last six months. The case manager checks medical guidance and confirms that Fluoxetine can be prescribed for depression.
The case manager requested a case discussion to better understand John’s needs and when a change is likely to be expected. The Practitioner confirms that due to John’s treatment, engagement with support services and medication, they would expect John to see improvements, and that a change would be expected. The Practitioner notes that John’s dosage of Fluoxetine is the lowest dosage, and that typically a GP would increase it after 3 or 4 weeks if needed. Given this low dosage, it is possible that once John’s needs have stabilised his GP may gradually reduce how often John takes his Fluoxetine over a period of weeks or months to avoid symptoms such as body aches or nausea.
The case manager awards John the standard rate for the Daily Living component, and no award for the Mobility component. They determine that John’s award should be reviewed in two years.
The case manager sets out in John’s determination letter that his award will be reviewed in two years as there is a likelihood that his circumstances will change following treatment and engagement with support services. The case manager also says in John’s determination letter that he will likely need to provide new supporting information, and that an update on his Daily Living needs would be needed. This is so that his needs at the time of his next review can be fully understood.
Example 2: The case manager making a current decision does not ask for the individual to provide new supporting information at their next review
Sarah is 59 and has rheumatoid arthritis. The case manager familiarised themselves with Sarah’s application and supporting information. Sarah’s arthritis is widespread in her hands, causing significant pain and limited hand movement. In her application, Sarah noted that she is also at the early stage of arthritis developing in her feet.
Sarah provided confirmation from a professional. This was from her consultant rheumatologist, confirming Sarah’s condition and that she is starting a new medication that might improve her symptoms.
Based on the information available, the case manager awards Sarah the standard rate of the Daily Living component, and no Mobility component. The case manager expects that Sarah’s need might change, given she is both:
- starting a new medication
- has arthritis developing in her feet.
They determine that Sarah’s award should be reviewed in three years.
The case manager sets out in Sarah’s determination letter that her award will be reviewed in three years as her circumstances might change as she is starting new medication to ease her symptoms and has told us about developing arthritis in her feet.
The case manager considers the supporting information that Sarah has provided. It confirms her condition, rheumatoid arthritis, which is a long term condition which will remain despite any treatment to manage her symptoms. Although the supporting information will not be recent, it will still be relevant to Sarah’s circumstances at review. Therefore, the case manager does not ask Sarah to provide any new supporting information at her review.
This means at the next review, when the case manager familiarises with Sarah’s review form and existing information provided, they will see that Sarah has already provided confirmation from a professional for rheumatoid arthritis. They can use this when considering the detail Sarah provides on whether her needs have changed, or remain the same.
The content of the supporting information
When thinking about value, consider if the information:
- includes additional detail not provided on the application or review form
- relates to the individual’s experience of their condition rather than general information about that condition
- is broadly consistent with the information in the application or review form, or there is a reasonable explanation for any inconsistencies
Make sure you fully understand any specialist language or terminology used. This is so you can correctly interpret the information. If you need to check what something means, use other decision making tools, such as medical guidance or a case discussion.
Do not treat supporting information from abroad any differently. If you need to request translations, see accessibility guidance.
The supporting information provides additional information
You may conclude that a piece of supporting information is valuable if it contains additional details not provided in the application or review form.
You should not automatically disregard additional information that is relevant if it is inconsistent with other information. You should consider whether there is a reasonable explanation for the inconsistency. If there is no reasonable explanation, you should follow the guidance on inconsistencies below.
The supporting information relates to the individuals experience of their condition
Supporting information is valuable where it is an account of how the condition impacts the individual on a day-to-day basis or provides details on their needs.
Supporting information may offer lots of additional detail about the condition in general.
For example, information from a factsheet, a leaflet or a medical website. However, this is not valuable as it does not give you any insight into how that condition impacts the individual or their needs.
The same piece of information is valuable whether the source has seen what they are reporting for themselves or it is something they have been told.
Where supporting information indicates that what they are reporting is not something they have seen themselves but is something the individual has told them, you should not treat this information any differently.
Treating the information differently could disadvantage individuals who do not have contacts who regularly see their day-to-day needs.
You should continue to take a trust-based approach to this information, as always.
Medical professionals are unlikely to see the individual at any great length when they do see the individual. There are also some aspects of an individual’s care that it is unreasonable to expect certain professionals to see for themselves, such as night time toilet needs.
As a result, their insights on certain needs may only come from what the individual has told them.
Differences in describing levels of need
Some sources of supporting information will have a point of reference that impacts how they describe an individual’s needs. The way in which people they regularly come into contact with are impacted by their condition, the nature of the conditions the people they see often have, and the prognoses they are used to discussing will all impact their perspective. You should consider the source and the context when reviewing supporting information.
For example, a GP might describe an individual’s condition as ‘well-controlled’. They might choose that term because they know their condition has the potential to be very difficult to treat with medication and could routinely become very severe.
A condition being well controlled does not necessarily mean that the individual will not have any daily living or mobility needs. It may simply mean that the way they are impacted by their condition is consistent. The GP may use ‘well-controlled’ to indicate a range of circumstances, including that the individual:
- is prescribed treatment for their condition and consistently takes it as directed;
- has a condition which does not impact on them currently;
- has a condition which is stable and consistently impacts them in the same way
An alternative example is a social worker whose clients are mostly people with drug and alcohol addiction who are regularly in contact with the criminal justice system. They might describe a client who has significant depression but is not affected by substance misuse as capable of meeting their daily living needs. That may be the case when compared to the lives of their other clients, but it does not necessarily mean the client does not experience difficulty in looking after themselves.
It is important to remember that all subjective terms, such as mild, stable, well behaved, easily managed etc require a judgement to be made by the person using them. They should not be seen as definitive and the wider context in which they are made must be considered.
Related reading
- What is supporting information
- Principles of decision-making
- Our approach to supporting information
- supporting information operational guidance
- Types of professional
- other decision making tools
- accessibility guidance
- the backwards and forwards test