Black Country Healthcare NHS Foundation Trust

3. Miss R complains about the care and treatment provided to her by Black Country Healthcare NHS Foundation Trust between November 2024 and November 2025. She complains the Trust

• led her to believe she was starting long-term psychodynamic therapy in November 2024 and then changed it to time-limited therapy without informing her • ended her psychodynamic therapy in November 2025 after a limited number of sessions, without a clear explanation.

4. She says the abrupt ending of psychodynamic therapy, without clear explanation or supported transition, caused distress, emotional destabilization and fear of relapse. This impact has been ongoing since the therapy ended in late 2025. She says as she has a history of trauma, the loss of a safe and consistent therapeutic relationship has had a profound effect on her wellbeing. It increased anxiety, uncertainty, and the need for additional support, rather than helping her move towards stability.

5. As a result of bringing her complaint to us, Miss R seeking financial remedy of £13,000 to fund private therapy as well as service improvements and an apology.

6. Miss R was diagnosed with Emotionally Unstable Personality Disorder (EUPD) in 2022 and ADHD in 2023. She says she has also had 14 different traumas in her past which affect her mental health.

7. Miss R was placed on a waiting list for one-to-one psychological therapy in 2022 and progressed through the STEPPS/Stairways pathway to help her in the interim.

8. Miss R began what she understood to be Long Term Therapy in November 2024. She says the therapy ended in November 2025 following a limited amount of sessions.

9. Miss R complained to the Trust on 22 September 2025, and the Trust sent its response on 6 January 2026. Miss R brought her complaint to us on 21 January 2026.

11. The law says we cannot investigate a complaint where a person has (or had) the option to take legal action, unless we consider this is (or was) unreasonable in the circumstances. We have discussed this with Miss R to understand her circumstances and the outcomes she wants to achieve. We do not consider whether legal action would succeed but whether it would be a reasonable option to look into.

12. Miss R says the Trust were negligent in her care and failed to carry out appropriate care and treatment. She says ending psychodynamic therapy, without clear explanation or supported transition, caused distress, emotional destabilisation and fear of relapse, and this has continued since late 2025. Given her history of trauma, losing a safe and consistent therapeutic relationship has had a profound effect on her wellbeing, increasing her anxiety, uncertainty and need for support, rather than helping her move towards stability. She says has now been left in a vulnerable state and has had to go into hospital when suffering a mental health crisis. This means Miss R might be able to bring a claim of clinical negligence.

13. Miss R is seeking an apology, service improvements and financial remedy of £13,000. The amount of financial remedy Miss R seeks is at the higher end of our severity of injustice scale at level 6.

14. This scale allows us to ensure the recommendations we make are consistent and transparent for everyone who uses our service. The figures included in the scale represent the Ombudsman’s judgement about the sort of sums that are both appropriate and proportionate for us to recommend. The scale contains six different levels of injustice that a complaint could fall into, which increase in severity. Each level is then linked to a range of financial amounts we would usually recommend in those circumstances.

15. A court would be able to carefully consider and assess an appropriate amount of compensation for the impact Miss R says this had on her. A successful clinical negligence claim can often attach a larger financial sum than we might recommend on our scale. We would not want to disadvantage her by ‘under settling’ the complaint or proceed with an investigation, as we are unlikely to be able to achieve the level of financial remedy she is looking for.

16. Miss R is also seeking an apology and service improvements. While legal action would focus on financial remedy, it may also include some other outcomes. Pursuing a clinical negligence claim could potentially achieve and apology and service improvements too as a by-product of a successful claim.

17. We asked Miss R if she has any barriers to pursuing legal action and she told us she would be willing to speak to solicitors but is worried she might find the process stressful. Speaking to solicitors about a complaint is not different to speaking to us. In some ways, the legal process can be easier due to the fact solicitors would be on the complainant’s side acting on their behalf, whereas we are an independent and impartial service and do not take sides.

18. Taking all of this into account, we believe is it reasonable for Miss R to pursue legal action. We have decided not to consider the complaint further on these grounds. The courts can independently review the complaint and decide whether there has been clinical negligence, and, if so, decide on what amount of financial compensation would be appropriate.

19. If Miss R is unsuccessful in obtaining legal representation, or following taking legal action she has outstanding outcomes that could not be obtained through the courts, she can return to us, and we will consider whether to reopen her case. She will need to return to us as quickly as possible, to ensure that she returns within our one-year time limit. We hope this information helps Miss R progress her complaint and achieve the outcomes she is seeking.