Diagnostic Reconsideration and Re-referral Policy

PurposeThis policy explains our approach to requests for diagnostic reconsideration following completion of a neurodevelopmental assessment. It aims to ensure that all individuals receive a fair, consistent and evidence-based assessment while maintaining the integrity of the diagnostic process.Our ApproachOur assessments are undertaken using nationally recognised diagnostic standards and involve a comprehensive review of all available clinical information.Diagnostic decisions are made following multidisciplinary team (MDT) discussion and are based on the evidence available at the time of assessment. This includes information gathered from clinical interviews, observations, developmental history, questionnaires, school or workplace information (where available), and any additional supporting documentation submitted before the assessment.The MDT carefully considers all available evidence before reaching a diagnostic conclusion.Diagnostic DecisionsOnce a diagnostic conclusion has been reached by the multidisciplinary team, the assessment is considered complete.A diagnosis will only be made where there is sufficient evidence to demonstrate that the relevant diagnostic criteria are met. Equally, where there is insufficient evidence to conclude that the criteria have been met, a diagnosis cannot be given.A conclusion of "criteria not met" or "insufficient evidence" is a valid clinical outcome and reflects the evidence available during the assessment process.Requests for ReconsiderationWe do not routinely offer diagnostic reconsideration or redetermination once the multidisciplinary team has reached a final diagnostic conclusion.This approach is increasingly adopted by neurodevelopmental assessment providers because reopening completed assessments requires substantial additional clinical time and resources, often involving a repeat review of the entire assessment rather than a simple review of individual pieces of evidence.Reconsideration would also create inconsistency between individuals who provided complete information during the assessment process and those who submitted additional evidence after a diagnostic decision had already been made.Providing Information Before Your AssessmentIt is the responsibility of the individual, or where appropriate their parent, carer or representative, to provide all relevant information before the assessment is completed.This may include:Developmental history.
School reports.
Educational records.
Previous assessments.
Medical reports.
Occupational reports.
Questionnaires.
Supporting letters.
Any other information requested by the clinical team.
Providing this information before the assessment allows the multidisciplinary team to consider the fullest possible picture when reaching a diagnostic conclusion.Information Received After the AssessmentInformation submitted after the multidisciplinary team has reached its final decision will not normally be added to the completed assessment or used to reopen the diagnostic decision.This is because the assessment reflects the evidence available at the time the clinical decision was made.Exceptional CircumstancesIn exceptional circumstances, we may review whether there has been a significant procedural error in the assessment process, such as:Relevant evidence submitted before the assessment not being considered due to administrative error.
A significant factual error within the assessment documentation.
Evidence that demonstrates the assessment process did not follow the agreed clinical pathway.
This is not a reconsideration of the diagnostic outcome itself but a review of whether the assessment process was conducted appropriately.Re-referralIf significant new evidence becomes available after the assessment has concluded, or if an individual's presentation changes substantially over time, the appropriate course of action is a new referral for assessment rather than reopening a completed assessment.A new assessment allows the multidisciplinary team to consider all available evidence together within a structured diagnostic process, ensuring that any decision is based on a complete and contemporaneous clinical picture.A re-referral does not guarantee that a diagnosis will be made, but it ensures that any new evidence can be considered appropriately within a full assessment rather than retrospectively added to a completed one.Our CommitmentWe understand that receiving a diagnosis of "criteria not met" or "insufficient evidence" can be disappointing and, at times, frustrating. However, our clinicians have a professional and ethical responsibility to make diagnostic decisions based solely on the evidence available and the diagnostic criteria in place at the time of assessment.This approach helps ensure that all individuals are assessed fairly, consistently and in accordance with recognised clinical standards, maintaining the quality and integrity of the diagnostic process for everyone.