South London and Maudsley NHS Foundation Trust

4. Miss C represents her son, Mr C, about the care and treatment provided by the Trust’s Child and Adolescent Mental Health Services (CAMHS) between 2010 and 2024.

5. Mr C complains the Trust:

• declined five referrals from his GP before CAMHS accepted him • promised to refer him to the Service for Complex Autism and Associated Neurodevelopmental Disorders (SCAAND) but never did • delayed in diagnosing him with attention deficit hyperactivity disorder (ADHD) • did not provide him with a care plan for his ADHD • did not refer him to an ADHD nurse • delayed in arranging a psychiatrist appointment • psychiatrist prescribed incorrect medication for his ADHD • never arranged a second appointment to see a psychiatrist • did not support his referral and assessment for the Children With Complex Needs Service (CWCNS) • did not offer him conduct disorder support, cognitive behavioural therapy (CBT) or group-based ADHD focus in line with National Institute for Health Care Excellence (NICE) guidelines • never addressed his sleep disorder and did not complete a personal health budget (PHB) to get a specialist service for his sleep disorder • did not coordinate with his local authority’s special educational needs and disabilities (SEND) services and gave no input into his education, health and care plan (EHCP) or package of care for him and for Miss C • did not help with his disability living allowance (DLA) application • did not support him after a disclosing a traumatic event when he was younger • discharged him from CAMHS with no transition to adult services or ongoing referrals • did not offer or provide support for his mother as a parent carer.

6. Mr C says this caused a delay in his EHCP’s annual review being completed, for him to fall behind in his education, lack of faith in the Trust, depression, weight loss and made his sleep disorder worse. He explains discharging him from CAMHS with no transition has impacted his ability to access other services.

7. Mr C explains the Trust’s actions caused his mother to suffer from post-traumatic stress disorder (PTSD), delayed her recovery from lung cancer and a loss of faith in the Trust. He says the lack of support for his mother resulted in his sister ending up in crisis.

8. Mr C would like an acknowledgement of the failings, apology for the impact caused, service improvements and a financial remedy.

Complaints that are outside of the statutory time limit

13. The HSC Act 1993 (Section 9(4)), says we cannot accept a complaint if it is made more than a year after the day on which the person aggrieved first had notice of the matters in the complaint, unless we consider it reasonable to do so.

14. We have carefully considered Mr C’s and his mother’s date of knowledge regarding the individual complaints and addressed these separately below:

• CAMHS referrals

15. Mr C says the Trust declined five referrals from his GP before CAMHS accepted him. Miss C says the problems have occurred since 2010. She says the dates of the rejected referrals are August 2010, May 2014, March 2018, September 2020 and May 2021.

16. She explained that she ‘always knew that [Mr C] was not getting the right support, so the problem started with the initial rejections of the GP referrals.’ Based on Miss C’s account this would have been from 2010.

17. Miss C did not complain about this in her initial complaint to the Trust in May 2024. In her response to the Trust (email in August) she referred to being refused by CAMHS five times. We consider it took her between 3 to 14 years from her date of knowledge (when she became aware she had reasons to complain) to complain to the Trust.

18. The Trust sent its final response to Miss C in late February 2025. She sent us the complaint form in early April. The complaint is between 3 years and 11 months, and 14 years and 8 months outside the statutory time limit.

• ADHD diagnosis

19. Mr C complains the Trust delayed in diagnosing him with ADHD. Miss C says her son was diagnosed with ADHD in 2022.

20. Miss C says the problem started with the initial rejections of the GP referrals. She says there was a referral before 2016 that CAMHS rejected and another referral in 2016. She says she could not understand why he was not being accepted. She says she was not aware how bad it was until she read the NICE guidelines about what the Trust should have been doing to support him. She says she then complained to the Trust.

21. Miss C says she was unhappy with the service from CAMHS and tried to get them to support him better. She said she emailed all the health professionals involved for support and help, but no one did anything. She said this would have been in 2020/2021.

22. Based on the information provided by Miss C and the Trust, it carried out an initial ADHD assessment in 2021 and did not diagnose Mr C as having ADHD at that time. A further assessment was carried out by the Trust’s Service for Complex Autism and Associated Neurodevelopmental Disorders (SCAAND) in mid-September 2022, when it diagnosed him as having ADHD.

23. Miss C did not specifically complain about this in her initial complaint to the Trust in May 2024. However, the Trust dealt with the issue of delay in diagnosis and treatment in its complaint response (August 2024).

24. She sent us her complaint form in early April 2025. We consider Miss C would have been aware of the problems with the delay in ADHD assessment and diagnosis by the latest 2016, this complaint is about eight years outside the statutory time limit.

• Care plan, referral to ADHD nurse and psychiatrist appointment

25. Miss C says she always knew her son was not getting the right support and she was not sure how bad it was until she read NICE guidelines about what the Trust should have been doing to support him.

26. Following the Trust’s ADHD assessment in September 2022, it sent out its ADHD report to Miss C, which included a list of recommendations. Miss C believes the referral to an ADHD nurse should have been done when the Trust diagnosed her son in September 2022. Miss C says she became aware of the delay in arranging a psychiatrist appointment by the late January 2023. This is based on emails from Miss C to the Trust at this time.

27. Mr C’s EHC (Education, health and care) needs assessment – completed by Miss C – in early January 2023, shows that Miss C had concerns about there being no treatment/care plan implemented by the Trust following SCAAND’s ADHD assessment and MDT meeting in December 2022. This form also indicates she was aware of the NICE guidelines by early January 2023.

28. From Miss C’s supporting information, we consider she was aware of the lack of care plan and ADHD nurse following the diagnosis and recommendations in September 2022, and psychiatrist appointment by January 2023.

29. Miss C complained about the lack of a care plan in mid-May 2024 and she complained about an ADHD nurse and psychiatrist appointment in June.

30. It took Miss C between 17 months and 23 months from her date of knowledge to complain to the Trust. She sent us her complaint form in early April – this complaint is between about one year and three months, and one year and seven months outside the statutory time limit.

• Sleep disorder and personal health budget (PHB)

31. Mr C complains the Trust never addressed his sleep disorder and did not complete a PHB to get a specialist service for his sleep disorder.

32. Regarding her son’s sleep disorder, Miss C says she was aware of this ever since her son was three years old (August 2010). In later communication with us, she explained her son was diagnosed with Non-24-Hour Sleep Wake Disorder in 2021 and the Trust never offered support.

33. Regarding the PHB, she says after speaking with a sleep service who at the time were commissioned by the NHS in another area, they advised her to ask for a PHB and talk to CAMHS. She says this was in 2022. She says she contacted the Trust and they agreed to do it. However, it just wrote to the GP requesting they do it and no one ever did it. She says she then wrote to her local integrated care board (ICB) to request a PHB in 2023.

34. Miss C did not raise this in her first complaint dated May 2024.

35. Following her complaint, she sent a further email to the Trust in early June. She says she wanted an outcome to financial support for sleep disorder and felt she was getting no help to do so.

36. We consider Miss C was aware of the problems regarding support for sleep disorder by 2021 at the latest and PHB by 2022. It took Miss C between two to three years to raise a complaint with the Trust. We received her complaint between three and four years after her date of knowledge. This complaint is two to three years outside of the statutory time limit.

• Coordinate with local authority and input into education, health and care plan (EHCP) or package of care.

37. Mr C complains the Trust did not coordinate with his local authority’s special educational needs and disabilities (SEND) services and gave no input into his EHCP or package of care for him and for his mother. Based on the evidence from Miss C (email to the Trust in May 2023), she was aware of the problem by the latest in May 2023 and more than likely earlier.

38. Mr C’s medical records show she spoke to the Trust’s Care Coordinator saying she had not received any support from CAMHS since her son was diagnosed with ADHD by SCAAND, specifically with the process of applying for an EHCP – late March 2023. The medical notes show Miss C put a request for EHCP assessment in early January 2023.

39. Miss C did not raise this as a complaint to the Trust in May 2024. She complained about a lack of support regarding the EHCP in early August – about 15 months after her date of knowledge. She brought this complaint to us in April 2025 – one year and eleven months after her date of knowledge, eleven months outside of the statutory time limit.

• DLA application

40. Mr C complains the Trust did not help with his DLA application.

41. Miss C says her friend told her about DLA. She says she did not know what it was. She explains it took her several months of being signposted around in circles and in the end it was a helpline who told her how to apply for DLA. She says the delay meant her son missed out on one year’s worth of DLA.

42. Miss C provided us with emails (from the Department of Work and Pensions - DWP) to show her son was getting DLA from November 2022. Therefore, it is more than likely she was aware about DLA in late 2022 or earlier.

43. She did not raise this as a complaint in May 2024. She did however make reference about DLA in her response to the Trust in early August and lack of benefits advice.

44. It took Miss C about two years to raise a complaint with the Trust and two years and eight months to raise a complaint to us. This complaint is one year and eight months outside of the statutory time limit.

• Support as a parent carer

45. Mr C complains the Trust did not offer or provide support for his mother as a parent carer (for example parenting strategies and parent training). Miss C says she first became aware of this following her son’s ADHD diagnosis in September 2022.

46. Miss C raised a complaint to the Trust about parenting training in May 2024 - one year and eight months from her date of knowledge. It took her two years and seven months to bring her complaint to us - one year and seven months outside of the statutory time limit.

• Conduct disorder support, CBT and group-based ADHD focus

47. Mr C complains the Trust did not offer him conduct disorder support, CBT or group-based ADHD focus and support for his ADHD in line with NICE guidelines. Miss C says she first became aware her son should have been offered these services when she read the NICE guidelines, just before she put in the complaint in May 2024.

48. Within Miss C’s EHC needs assessment form - early January 2023 – it is evident she was aware of the NICE guidelines at this time. In her email to us in late September 2025 she said she read the guidelines in 2023.

49. From Miss C’s supporting information, we consider she would have been aware of the NICE guidelines and what the Trust had not done by early January 2023 at the latest. She was unhappy with the Trust and had opportunity to raise a complaint sooner. Miss C raised a complaint to the Trust in May 2024.

50. We consider it took Miss C about 16 months from her date of knowledge to raise a complaint with the Trust. She sent us her complaint form in early April 2025 – this complaint is one year and three months, outside the statutory time limit.

51. For us to move the time limit to one side we must be satisfied the explanation given is reasonable.

52. We asked Miss C why she did not raise her complaints to the Trust and us sooner than she did. She says she was not aware how many times her son had been referred and rejected (CAMHS referrals) and was not aware how bad it was until she read NICE guidelines about what the Trust should have been doing to support him. She said it was at this point she raised a complaint.

53. Miss C explains her own neurodiversity means she struggles with official processes and does not know how to access support and how to ask for help.

54. We have carefully listened to Miss C’s explanation for the delay in complaining to the Trust and then us. We are sorry to learn of her difficult caring responsibilities and the struggles with her own neurodiversity and how this impacts her in seeking support.

55. There are several free independent NHS advocacy services that could have assisted Miss C in raising a complaint with the Trust and us sooner than she did, as well as explaining about the legal time limits. Miss C could have sought assistance from the Trusts’ PALS to raise and escalate her complaint, who would have also explained about the legal time limits.

56. Miss C has other complaints with us relating to other hospital trusts (not related to this complaint). This shows she was raising complaints at least by 2023. This indicates she had the ability and opportunity to raise her complaints with the Trust sooner.

57. We have taken into account the length of time this complaint was in local resolution. We do not consider there was any undue delay – on behalf of the Trust - in responding to this complaint. This is because the Trust responded within six months of receiving the complaint in line with Regulations 2009.

58. The Trust’s website provides details of advocacy services to help someone making a complaint. If the person is not happy with how the Trust has dealt with their complaint, it explains how they can bring their complaint to us and about the 12-month time limit.

59. Our website explains there is a 12-month time limit for making a complaint to us.

60. Although we recognise Miss C’s reasons for delay, the onus is on the complainant to make enquiries (with the organisation – in this case the Trust) when they are unhappy with the care and treatment they receive or think they should be receiving. Raising this as a complaint brings it to the attention of the organisation and allows it the opportunity to address the issue and if appropriate offer a suitable resolution.

61. We acknowledge the difficulties she faced. We are not persuaded there was any significant barrier during the majority of the time between the date of knowledge and the point she came to us. Although we acknowledge the struggles and difficulties she experienced may cause some delay, we are not satisfied the total length of time taken in bringing the complaint to us is reasonable for us to move the statutory time limit to one side. We cannot investigate Mr C’s complaint any further.

62. We are aware that Miss C had an operation in March 2024 regarding lung cancer. Although she has not said this was a cause for her delay in raising her complaint with the Trust and us, we have taken this into account in our considerations. We are of the view this would have caused some delay. However, she did raise a complaint with the Trust not long after this procedure (May 2024) and therefore, we do not consider this was a significant barrier in raising her complaint with the Trust and then us.

63. We recognise it will be disappointing for Miss C and her son that we cannot investigate these complaints and hope we have explained the thorough consideration we have given to our decision and clearly outlined the reasons for it.

Support following disclosure of traumatic event and discharge

64. Mr C complains the Trust:

• did not support him after disclosing a traumatic event when he was younger • discharged him from CAMHS with no transition to adult services or ongoing referrals.

65. Miss C says she did not make a formal complaint because she says she cannot keep raising complaints all the time as its exhausting. She says she already has about seven complaints in place about all different things and cannot keep track. She says she did not complain because she has learnt that it makes no difference when she does. The process of complaining traumatises her.

66. There is no evidence to demonstrate Miss C has raised these complaints with the Trust.

67. In health cases, section 4(4) and (5) of the HSC Act 1993 prevents us from conducting an investigation unless we are satisfied the complaints process has been used and exhausted, or it was not reasonable to expect the complainant to have done so.

68. In line with the HSC Act, we cannot investigate these aspects of her son’s complaint. This is because there is no evidence she or her son have raised this with the Trust and given it opportunity to respond. His complaint is not yet ready for us. We have listened to Miss C’s explanation for why she decided not to complain to the Trust about these issues, but we still think it would be reasonable for her to do so.

69. At the time we identified these complaints were not ready for us, we were still considering other aspects of Mr C’s complaints. We explained to Miss C in January 2026 that we cannot investigate these specific complaints because there is no evidence these have been raised with the Trust. We provided details of what she should do to raise these complaints with Trust and what to do after she gets a response. Miss C has not provided us with evidence she has raised this with the Trust. We cannot progress this complaint any further.

Prescription of medication for ADHD

70. Mr C complains the psychiatrist prescribed incorrect medication for his ADHD. Miss C said the titration (process of introducing medication safely and adjusting the dose until it is optimised) guidelines in NICE were not followed, and they did not carry out baseline cardiovascular assessment or electrocardiogram (ECG) prior to her son being prescribed ADHD medication.

71. The Trust said the psychiatrist explained the benefits and risks of different medication with Miss C and her son during a consultation in late 2023. It said Mr C decided to trial Methylphenidate (used to treat ADHD). The psychiatrist said Miss C was concerned this was contraindicated (where medication or treatment should not be used in a particular situation) for young people with epilepsy. It said in its response there was no contraindication to this medication in young people who have a vulnerability to epilepsy.

72. It explained the psychiatrist rang Miss C two weeks after the consultation to see how her son was managing the medication and she told the Trust he was choosing not to take it.

73. In a meeting between the Trust and Miss C in early June 2024, Miss C said her son was prescribed stimulant medication. She said she read the leaflet which said it was not suitable for somebody with epilepsy. She explained her son is vulnerable to epilepsy and this made her anxious about him taking this. She said her son took this medication once.

74. The medical notes indicate the psychiatrist prescribed Mr C Methylphenidate ADHD medication in mid-2024. Our adviser said this was in line with NICE: Attention deficit hyperactivity disorder: diagnosis and management, as first line intervention.

75. Miss C had some concerns this medication might be contraindicated due to her son’s brain MRI (magnetic resonance imaging) scan, suggesting he is at risk of epilepsy. However, our adviser said the psychiatrist had double checked with the paediatricians who clarified there was no contraindication.

76. We recognise Mr C’s concerns about the prescribed medication. Informed by clinical advice, the medication prescribed by the Trust was in line with NICE guidelines. There is no indication of a failing.

77. Within Miss C’s email to the Trust in early August - following its complaint response - she said her son never took this medication because of her concerns. During our introductory call with Miss C in 2025 and an email to us in 2026, she confirmed her son never took the ADHD medication.

78. Even if the Trust should not have prescribed the medication, there is no evidence of a clinical impact. This is because the evidence from Miss C and the Trust indicates Mr C never took this medication.

Referral to Service for Complex Autism and Associated Neurodevelopmental Disorders (SCAAND)

79. Mr C complains the Trust promised to refer him to SCAAND but never did.

80. Miss C explains the referral to SCAAND was to treat her son’s ADHD as the complexity of his sleep disorder and brain dysplasia make medication and treating his condition complex. This was following the first referral to SCAAND in 2022 when they diagnosed her son with ADHD.

81. The Trust did not specifically respond to this complaint.

82. The medical notes indicate the initial referral (2022) from the Trust’s CAMHS to SCAAND was for a second opinion for an ADHD assessment. Once SCAAND completed its assessment and confirmed the ADHD diagnosis (September 2022), SCAAND provided the diagnostic report and recommendations for treatment and discharged Mr C from its service in December 2022.

83. Miss C contacted SCAAND herself when she received information of the discharge in December, requesting it provide the ADHD treatment, due to the complexity of her son’s conditions.

84. SCAAND advised Miss C this is not in its remit. It explained it will only accept a referral from the Trust’s CAMHS if its psychiatrist – within its ADHD treatment pathway - sees Mr C and after trying medication, feels they are ‘stuck’ and needs SCAAND’s input.

85. Being ‘stuck’, means the psychiatrist seeing a patient regarding their medication concerns and trying alternatives as necessary - based on their skill and experience - and reviewing and assessing progress. If none of the alternatives worked and they were not sure what to try next, they would be ‘stuck’ and seek referral to SCAAND for further advice.

86. SCAAND also advised Miss C to try the local services first, starting with behavioural interventions and suggested Mr C would be seeing a different set of clinicians in the ADHD treatment pathway so should wait and try these first. SCAAND double checked with the Trust’s CAMHS care co-ordinator that Mr C was referred to the local ADHD team and suggested he was prioritised for a medication appointment.

87. In September 2024, Miss C requested a re-referral to SCAAND. Our adviser said this appears to be due to a disagreement between her and the Trust’s CAMHS’s Psychiatrist regarding prescribed ADHD medication.

88. The records show that Mr C was not taking the prescribed first line ADHD medication Methylphenidate.

89. In early September 2024, Miss C sent an email to SCAAND. She explained the Trust’s Family Therapist said a referral had been made but SCAAND refused the referral. Miss C said she understood from the email from SCAAND in mid-December 2022 that her son could be referred to SCAAND if medication became an issue.

90. However, SCAAND - within an email to Miss C and CAMHS in early September 2024 - explained that in relation to medication issues:

‘At present, we are unlikely to have capacity to help in this way given the huge demand on CAMHS, and I understand from the letter she attached that [name of the CAMHS psychiatrist] is happy to meet [Mr C] and you.’

91. SCAAND reiterated the referral criteria, in that it would only accept a referral if treatment had been tried but there were clinical challenges to this being effective.

92. In early September, SCAAND replied again to Miss C after she was unhappy it could not help. SCAAND said should a referral be made from CAMHS to its service this will be reviewed against its service eligibility and she will be copied into the response to the referrer.

93. On the same day, Miss C emailed the family therapist asking her son to be referred to SCAAND. The therapist said they will discuss with the psychiatrist when they get back from leave.

94. The Trust’s Family Therapist emailed Miss C in early September 2024. They attached a couple of clinical letters, one of which was Mr C’s care plan made at the end August. One of the care plan actions said:

‘[Mr C] to be referred back to SCAAND so that his complex medication needs can be addressed. To be actioned immediately.’

95. However, within the family therapist’s email in early September, they explained they will discuss with the psychiatrist when they return from leave about Miss C’s request for a referral back to SCAAND as the psychiatrist will need to request they need specialist support to manage the treatment of Mr C’s ADHD.

96. The evidence shows Mr C’s mother requested a referral to SCAAND and emailed SCAAND herself. They advised Miss C they will only accept referral from the local psychiatrist after they have exhausted local options.

97. Miss C requested a SCAAND referral again with the family therapist who agreed to discuss this request with the local psychiatrist.

98. Following Miss C’s concerns (September 2024), the psychiatrist offered further appointments to review Mr C (mid and late September 2024 and dates in October), but Miss C did not accept these as they clashed with her son’s sleep schedule and/or her work. This therefore could not be progressed as none of the offered appointments were suitable.

99. Our adviser said the psychiatrist could not have made a referral to SCAAND, having not been able to review Mr C, discuss the medication concerns and try alternatives, as this is a requirement before referring to SCAAND.

100. Our adviser said the Trust’s actions were in line with SCAAND’s referral criteria (outlined in their email to Miss C in December 2022) that they will only accept a referral from the local CAMHS psychiatrist if they have tried local options and are ‘stuck.’

101. We recognise Mr C’s concerns about the SCAAND referral. The evidence shows Miss C wanted a SCAAND referral and this was listed on his care plan. The SCAAND’s referral criteria, as outlined in its emails to Miss C in December 2022 and September 2024, meant it could only accept a referral from the psychiatrist if Mr C had tried medication and if needed, alternatives, that had not worked and the psychiatrist were not sure what to try next.

102. The records show Mr C was not taking the prescribed first line ADHD medication Methylphenidate and the psychiatrist had not had opportunity to meet Mr C, despite the psychiatrist offering appointments. We consider the Trust’s actions in not making the referral was in line with SCAAND’s referral criteria. There is no indication of a failing.

Arrange a second psychiatrist appointment

103. Mr C complains the Trust never arranged a second appointment to see a psychiatrist.

104. Miss C said this was following the initial appointment with a psychiatrist in December 2023. She says her son never had another appointment. She says she requested a different psychiatrist because she lost trust in the first psychiatrist her son saw. She says this is because they prescribed the wrong kind of medication and lied to her about the listed side effects.

105. The Trust has not specifically responded to this complaint.

106. The relevant guidance is:

• GMC: Decision making and consent. This explains that patients have the right to be involved in decisions about their care, supported to make informed choices, and to engage in meaningful dialogue with healthcare providers. They should be listened to, provided with relevant information, and given sufficient time and support to understand and make decisions about their treatment.

• NICE: Shared decision making. This explains that shared decision-making is a collaborative process where patients and healthcare professionals work together to decide on immediate or future care. It empowers patients to choose the care that suits them best, including the option of no treatment or maintaining their current approach.

107. Our adviser said that in line with GMC and NICE guidance the Trust should have explored with Miss C what her concerns were regarding the psychiatrist, what was the basis of the disagreement and attempted to resolve it locally. This could have been through a further consultation with the allocated psychiatrist and if necessary, with an alternative psychiatrist in the team if available.

108. Our adviser said the medical records show the psychiatrist did explore options of Mr C being seen by an alternative psychiatrist locally, but after some consideration, Miss C decided to stay on with the Trust’s CAMHS.

109. The medical records also show the Trust’s psychiatrist offered further appointments to review Mr C in September and October 2024, but Miss C did not accept these as they clashed with her son’s sleep schedule and/or her work.

110. We are sorry to learn of Mr C’s complaint. We have carefully considered his mother’s account, the medical records and independent clinical advice. The weight of the evidence indicates the Trust explored options of Mr C seeing an alternative psychiatrist locally in line with the above guidance. It also agreed to meet up with Mr C and his mother to discuss the difficulties they were facing, but unfortunately Miss C was unable to attend these. We cannot be critical of the Trust.

Referral to Children With Complex Needs Service (CWCNS)

111. Mr C complains the Trust did not support his referral to the CWCNS for an assessment. (This service provides support to children and young people with complex needs). Miss C says she had to do the referral herself and as a result it was rejected. She says this was in late 2023.

112. The Trust has not specifically responded to this complaint.

113. The relevant guidelines are:

• GMC: Decision making and consent, as explained earlier.

• GMC: Leadership and management. This says; ‘It is essential for good and safe patient care that medical professionals work effectively with colleagues from other health and social care disciplines, both within and between teams and organisations.’

• NICE: Shared decision making. This guidance explains; ‘Shared decision making is a collaborative process that involves a person and their healthcare professional working together to reach a joint decision about care.’

114. The medical records show that Miss C was struggling with her own health needs as well as Adult ADHD and managing two children with neurodiversity. She repeatedly requested practical help as she was struggling as a single parent in the above context. Our adviser said a referral should have been made to social services for support, with Miss C’s consent.

115. The medical records indicate that Mr C’s Paediatrician had previously referred him to social services but the referral was not accepted.

116. Our adviser said Miss C then requested the family therapist in the Trust’s CAMHS team for a carers’ assessment and they advised her this would be the remit of social services, not the Trust and they would need her written consent to make that referral to social services. The Trust asked her if she would like to make an appointment with CAMHS to discuss this and help her with completing an application to social services. Our adviser said the notes do not indicate that Miss C took up the Trust’s offer.

117. The medical records show that Miss C instead made the referral to social services herself, which she is entitled to make, and was accepted by social services (CWCNS) in December 2023.

118. Miss C provided us with an email dated mid December 2023 which she received from a social worker from the local authority’s CWCNS. The social worker confirmed that Mr C had been accepted by the CWCNS. This meant he would be allocated a social worker who would complete a children and family assessment to assess his needs.

119. We recognise Mr C’s concerns on whether the Trust did not support his referral to the CWCNS for an assessment. The evidence indicates the Trust requested Miss C’s written consent to make a referral to social services for support for Miss C and her son and it offered an appointment with CAMHS to discuss the referral and help to complete the relevant forms.

120. However, the medical records do not indicate Miss C took up this offer of help and decided to make the referral to social services herself. We consider the Trust’s CAMHS offered to assist Miss C in line with GMC and NICE guidance. We cannot see the Trust did anything wrong here.

121. We are sorry to learn of Mr C’s complaint about the Trust. Our primary investigation decision is not made without recognition of the impact his and his mother’s concerns have had, and we are sorry if our decision causes any further upset. We hope we have explained the thorough consideration we have given to our decision and clearly outlined the reasons for it.

1. We are sorry to learn of Mr C’s experiences with the Trust. We acknowledge the difficult circumstances around this complaint, and the impact this is having. We acknowledge this was and continues to be a difficult time for Mr C and his mother.

2. We have carefully considered the complaint about the Trust. Having done so, and for the reasons set out in this statement, we have decided not to investigate this complaint further.

3. Our decision is not made without recognition of the distressing circumstances around the events.