Decision on the PHSO website ↗ All PHSO decisions
The complaint, background, findings, decision and recommendations on this page are the PHSO's published words. First-person wording refers to the Ombudsman.
1. We have carefully considered Mrs W’s complaint about Avon and Wiltshire Mental Health Partnership NHS Trust (the Trust). We recognise how distressing Mrs W’s care has been, and we are very sorry to hear about what she has been through.
2. We consider Mrs W could take legal action on the matter she has brought to us. For this reason, we will take no further action. We appreciate that this is not the outcome Mrs W was hoping for, and we are sorry for the disappointment this may cause. We hope that the reasons we have given clearly explain our decision.
From: PHSO decision P-006079, 27 August 2026, on the PHSO website ↗
3. Mrs W complains about the treatment offered to her by the Trust. She says her OCD (obsessive-compulsive disorder, a condition that causes a cycle of unwanted thoughts and behaviours) is resistant to normal treatment and her treatment has not been stepped up appropriately.
4. Mrs W says this has caused increased distress and suicidal ideation. The only thing that was helping is that she would get specialist help for her OCD.
5. Mrs W is seeking a financial remedy in recognition of the emotional distress and trauma caused by the Trust.
8. 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.
9. We have discussed this with Mrs W to understand her circumstances and the outcomes she wants. We do not consider whether legal action would succeed but whether it would be a reasonable option to look in to.
10. Mrs W told us she is seeking a significant financial remedy in recognition of the emotional distress and trauma caused by the Trust. The courts are normally best placed to provide a financial remedy.
11. She told us she did not feel legal action was an option for her for the following reasons:
• Cognitive Barriers: Mrs W says she lacks the executive functioning required to comprehend complex legal guidelines, analyse disclosures, and meet strict court deadlines.
• Psychological Harm: Mrs W says the adversarial, confrontational nature of a legal dispute poses a severe risk to her psychological safety. She says she could not cope at all with this route with severe social anxiety, as well as her other mental health illnesses.
• Financial Anxiety: Mrs W says the thought of legal costs and complex court fees causes immense panic, which would further deteriorate her health.
12. We are very sorry to hear how Mrs W’s health affects her daytoday life, and that this has caused her understandable concern about pursuing a legal route.
13. In our experience, the legal route places a very similar level of expectation on the claimant as we place on someone bringing a complaint to us. Whilst we appreciate Mrs W’s concerns, this means it is very unlikely that Mrs W would need to interpret any more guidance or disclosures than she already has in pursuing a complaint with us.
14. A legal professional would normally do this for her, in much the same way that a caseworker would support her with a complaint. In addition, deadlines apply to both processes and, while they are strict, there is scope for flexibility in both where there is sufficient mitigation. On this basis, we cannot conclude that there are additional cognitive barriers associated with the legal process.
15. We recognise Mrs W’s concerns about her psychological safety and we do not underestimate the impact that any process can have on her mental health. Our understanding is that nearly all legal claims for clinical negligence are settled out of court and without direct confrontation.
16. If Mrs W did have a case that was not resolved in this way, there are ways for her to present evidence to a court that can take account of her health needs. For these reasons, we do not consider this to be a barrier to her taking legal action.
17. We also understand that legal costs can be very worrying and that Mrs W may be concerned about taking any financial risk. We are not suggesting that she should do so.
18. It is very common for these types of cases to operate on a no win, no fee basis, meaning Mrs W would usually not be liable for costs if a legal representative accepted her case. This is something that could, and should, be discussed in detail with any legal representative before a case is taken on.
19. Mrs W has told us that she received support from an advocate when putting her complaint to us, but that this advocate is not able to support her with a legal claim. Our view is that the information Mrs W has already provided to us could be shared directly with a legal provider to allow them to assess her claim.
20. If further information were needed, she could also seek support from another organisation, such as Citizens Advice, or a similar advice or advocacy service.
21. Considering the outcome Mrs W is seeking and the reason she did not initially consider a legal route, we are of the view that Mrs W does have the option of seeking legal advice about her concerns, and that this route is not barred by her health, cognitive needs, or financial situation.
22. We are very sorry that we are unable to take further action on Mrs W’s complaint, and we appreciate that this will be disappointing. We hope, however, that our explanation offers some reassurance and supports Mrs W in deciding what she would like to do next.