Clinical Outcome Review and Appeal Procedure

5.1 Purpose

This procedure applies where you disagree with an assessment outcome, believe the report contains a material error, or believe relevant information was not considered.

It is separate from a general service complaint, although the two processes may overlap.

5.2 No guarantee of a different outcome

A request for review does not guarantee that the assessment outcome will change. A different opinion from another provider does not automatically mean our assessment was incorrect.

Our assessment is based on the evidence available at the time and the client’s presentation during the assessment period.

5.3 Time limit

You should request a clinical outcome review within 4 months of receiving the assessment outcome or final report.

We may consider later requests at our discretion, but we are not required to do so.

5.4 What your request must include

Your request should be in writing and should explain:

• what part of the report or outcome you disagree with;
• what information you believe is missing, incorrect or misunderstood;
• why you believe the outcome should be reconsidered;
• any new or additional evidence you want us to review;
• what outcome you are seeking.

A general statement that you disagree with the outcome will not usually be enough to justify a full reassessment or panel review.

5.5 Initial review

We will review the request and decide whether it raises a material issue. We may consider whether:

• relevant information was unavailable or not considered;
• there is a factual error in the report;
• clinical reasoning requires clarification;
• new evidence materially changes the picture;
• further information, correction, addendum, panel discussion or reassessment is appropriate.

5.6 Possible outcomes

We may decide to:

• provide clarification;
• correct a factual error;
• issue an addendum;
• request further information;
• refer the case for further internal clinical review;
• reconvene or refer to panel where appropriate;
• recommend reassessment at a later date;
• decline the request if there is no material basis for review.

5.7 Second opinion

If you disagree with the outcome but cannot identify a material error or missing information, you may request a second opinion review.

Where available, this will be carried out by a suitably qualified clinician within The Neurodiversity Service who was not directly responsible for the original assessment. We may charge a fee for this service unless we decide otherwise.

A second opinion review may confirm the original conclusion, recommend clarification, or recommend further review.

5.8 Refunds

A refund is not provided on the basis of disagreement with the assessment outcome or where a different opinion is obtained elsewhere.

Refunds are considered under our Refunds, Cancellations and Rescheduling Policy and are based on the service provided, not whether a particular diagnosis was made.