Payment disincentives for vulnerable patients
NHS payment mechanisms that inadvertently disincentivise local systems from prioritising or providing adequate care for hard-to-reach patients.
Source spread
Where this theme appears
This theme appears across 11 independent accountability sources, so the source mix matters as much as the headline total.
20 inquiry recs
14 PFD reports
38 committee recs
1 CQC action
9 NAO recs
1 IMB rec
2 DHR recs
71 PHSO decisions
231 LGO/SPSO decisions
Browse by source
Source-grouped records are useful for tracing where a concern came from. Large sections show the 50 strongest matches for that source; counts still show the full theme total.
Inquiry recommendations(20)
30 — Enhance Professional Standards Unit independence and seniority
Recommendation: The Home Office must: take steps to enhance the independence of the Professional Standards Unit from the Home Office and the perception of this independence; and increase the seniority of the Head of the Professional Standards Unit so that they …
Gov response: 6.9.3. Whilst the seniority of the Head of the PSU will not be changed, the government is confident that the PSU operates within Advisory Conciliation and Arbitration Service (ACAS) Code of Practice on disciplinary procedures …
Not accepted
BRIS-142 — Prioritise quality and safety for specialist services; fund patient travel and accommodation
Recommendation: Where the interests of securing quality of care and the safety of patients require that there be only a small number of centres offering a specialist service, the requirements of quality and safety should prevail over considerations of ease of …
Unknown
HIA-4 — Compensation as Lump Sum Payment
Recommendation: We therefore recommend that compensation should take the form of a lump sum payment.
Gov response: No formal government response published. The Inquiry reported on 20 January 2017, the month the Northern Ireland Executive collapsed; the report The Executive Office and the Northern Ireland Office laid before Parliament in September 2019 …
Unknown
IR2-9 — Status of Awards and Legal Rights
Recommendation: I recommend that, with reference to the status of awards: a) eligible infected and affected persons should not be required to accept the offer of an award in full and final settlement of any right to pursue legal actions related …
Gov response: In line with recommendations 9 and 10 of the Second Interim Report, acceptance of an award does not require applicants to waive their right to pursue litigation. In defined circumstances, if an infected person's condition …
Accepted
IR2-8 — Tariff-Based Compensation Framework
Recommendation: I recommend that the Government should approve a scheme setting out a framework of tariff based compensation for eligible infected and affected persons, at rates which broadly take account of but are not limited by current practice in courts and …
Gov response: In line with recommendation 8 of the Second Interim Report, the Scheme will use a tariff-based framework to calculate the amount of compensation payable to those eligible. In practice, this means that compensation will be …
Accepted
IR2-6 — Categories of Loss and Award Heads
Recommendation: I recommend that the appropriate award in any case should be composed under the following categories of loss, applicable to both eligible infected and affected persons: a) an Injury Impact Award for past and future physical and mental injury, emotional …
Gov response: With respect to recommendation 6 of the Second Interim Report, the Government has accepted the Inquiry's recommended categories of award, and has therefore designed the Scheme to award compensation to include the following: Injury Impact …
Accepted
IR2-4 — Affected Persons Categories
Recommendation: I recommend that the following relevant affected persons should be admitted to the scheme: a) spouses, civil partners and long term cohabitees (for at least one year in the case of the latter) of living or deceased eligible infected persons; …
Gov response: With respect to recommendation 4 of the Second Interim Report, for those who have been affected by this scandal, affected persons will be eligible where their case is linked to that of an eligible infected …
Accepted
IR2-3 — Standard of Proof and Automatic Eligibility
Recommendation: As above, save that (a) the last bullet point should read: "eligibility is accepted if the information available points towards eligibility and the opposite cannot be shown to be more likely" and (b) eligibility should be automatic for individuals already …
Gov response: The Government acknowledges the further distress and trauma that can be caused to those applying for compensation, and so the Scheme has been designed to minimise the burden on applicants whilst protecting against fraud. People …
Accepted
IBI-1 — Compensation Scheme
Recommendation: My principal recommendation remains that a compensation scheme should be set up now
Gov response: This recommendation is accepted in full. The Inquiry was unequivocal that those who have suffered as a result of this scandal must be compensated for the harm that has been inflicted upon them. The UK …
Accepted
IBI-A-9a — Bereaved Partner Support Scheme
Recommendation: The IBSS cut-off date of 31 March 2025 be reviewed, that the scheme should as soon as possible reinstate support payments to partners bereaved after 31 March 2025 until such time as they receive compensation and that they should have …
Gov response: In his oral evidence to the Inquiry, the Minister for the Cabinet Office agreed to look again at the 31 March 2025 'cut-off' date for bereaved partners to join an Infected Blood Support Scheme. The …
Accepted
IBI-A-8b — Affected Estates
Recommendation: The Regulations be amended such that where someone who would be an eligible affected person dies between 21 May 2024 and 31 December 2029, their claim does not die with them but becomes part of their estate.
Gov response: In his oral evidence to the Inquiry, the Minister for the Cabinet Office agreed to look again at how the Scheme compensates the estates of affected people. The Inquiry originally recommended that it was beyond …
Accepted
IBI-A-7a — Unethical Research Award
Recommendation: Where there is evidence that an individual was the victim of unethical research practices IBCA should be authorised to make an unethical research practices award to that individual.
Gov response: The issue of unethical research is one of the most shocking areas of this scandal. In his oral evidence to the Inquiry, the Minister for the Cabinet Office agreed to look again at how the …
Accepted in part
IBI-A-6b — Exceptional Loss Evidence
Recommendation: The Cabinet Office consult on whether the evidential requirements for exceptional reduced earnings are likely to prove a barrier to people who have sufficient evidence that their eligibility for such an award could with confidence be established on a balance …
Gov response: The exceptional loss award which is part of the supplementary route provides additional compensation for those infected people who would have received higher pay if it were not for their infection. The Government commits to …
Accepted in part
IBI-A-6a — Financial Loss and Care
Recommendation: "x" be removed from the equation set out in Regulation 7.
Gov response: The Inquiry has raised concerns regarding the calculation of past care and financial loss awards for those who choose to continue receiving support scheme payments. The Inquiry has recommended that a formula in the regulations …
Accepted in part
IBI-A-4e — Evidence of Diagnosis Date
Recommendation: Regulation 14(2)(c) be amended to remove the requirement for evidence of the date of diagnosis of Hepatitis B or C. An appropriate redraft to achieve this would be: "where the diagnosis mentioned in sub-paragraph (a) is one of HIV, the …
Gov response: In order to aid processing of claims quicker, the Government has accepted the Inquiry's recommendation to remove the requirement for people with Hepatitis B or C to evidence their date of diagnosis with those infections …
Accepted
IBI-A-4d — Deeming of Severity Bands
Recommendation: Where the level of severity of a person's infection at Level 3 or more has been established to IBCA's satisfaction in relation to a given year, but it is not known when it reached Level 3 or more, the legislative …
Gov response: The Government acknowledges the concerns that the Inquiry has set out regarding the mechanism for determining the number of years a person with Hepatitis was likely to have spent at particular severity bands when there …
Accepted
IBI-A-4c — Effective Treatment - Earnings Floor
Recommendation: For the calculation of Financial Loss awards for Hepatitis B, people born after 1953 should be treated like those born in or before 1953 on provision of evidence that their health did not improve or that it remained difficult to …
Gov response: The Government acknowledges the concerns raised by the Inquiry regarding the calculation of financial loss awards for individuals with Hepatitis B or C. Currently the amount awarded is determined partially by reference to the introduction …
Accepted
IBI-A-4b — Special Category Mechanism
Recommendation: The Government reconsider whether to maintain its rejection in February 2025 of the recommendations of Sir Robert Francis KC and advice from the Infected Blood Inquiry Response Expert Group of August 2024, which was expressly accepted at the time by …
Gov response: In his oral evidence to the Inquiry, the Minister for the Cabinet Office agreed to look again at how the Scheme reflects the existing Special Category Mechanism and its equivalents. The England Infected Blood Support …
Accepted in part
IBI-A-4a — Interferon Treatment Impacts
Recommendation: People infected with Hepatitis B or C who have received a course of treatment with or based on interferon should be recognised as entitled to core awards at Level 3.
Gov response: The impact of interferon treatment on those infected with Hepatitis B or C often resulted in severe side effects, both psychological and physical. The Inquiry recommended that more be done to recognise the impact of …
Accepted in part
IBI-A-3a — HIV Eligibility Start Date
Recommendation: An amendment to the Regulations be made as soon as possible to remove the reference to 1 January 1982 from Regulation 3.
Gov response: In his oral evidence to the Inquiry, the Minister for the Cabinet Office agreed to look again at the Scheme's eligibility criteria for people infected with HIV. The Inquiry went on to recommend that the …
Accepted
Prevention of Future Deaths reports(14)
Nathaniel Phillips
Concerns: The coroner noted that brittle asthma is not covered by the medical exemption certificate, unlike other conditions requiring continuous medication. This created a financial barrier to obtaining prescriptions, which meant the GP did not escalate the patient's case or reassess asthma control.
Response (Department of Health): • The Department of Health explained that extending the list of medical conditions for prescription charge exemption would incur significant costs and raise fairness concerns. • The Department of Health … (AI summary)
Responded
Kristian Jaworski
Concerns: The coroner noted a presumption in favour of vaginal delivery, influenced by cost considerations, which required re-evaluation.
Response (Department of Health): • Officials contacted the Royal College of Obstetrics and Gynaecology (RCOG) for advice on the use of instruments in vaginal delivery. • The Department of Health provided details of RCOG … (AI summary)
Responded
Cerith Pugh
Concerns: The coroner noted that consultant referrals were routinely handled by middle-grade doctors first, and liver function tests were declined due to demand management without a clear mechanism for staff to override this policy for clinical necessity.
Response (University health Board): • The University Health Board issued the report to Hospital Directors and requested consultants review their practice to ensure direct consultant review or appropriate supervised delegation of referrals. • The … (AI summary)
Responded
Elaine Talbot
Concerns: The coroner noted that GPs lacked direct urgent access to CT scanning, unlike those in neighbouring areas, identifying this as a commissioning issue that could affect patient outcomes.
Overdue
Barbara Ellis
Concerns: The coroner noted difficulties in cross-border care provision where a patient's GP and social care commissioning are in different counties, leading to an inability to access therapeutic services.
Overdue
Alan MacDonald
Concerns: The coroner noted Addcounsel continued charging a patient for visits from a non-medically qualified director while an inpatient, despite no treatment being provided. Concerns were raised that the patient's financial worries were not addressed nor was NHS care access highlighted.
Response (Addcounsel): • Addcounsel has implemented system changes to ensure clients not receiving Addcounsel treatment are fully discharged to other services, with financial arrangements handled by the new provider. • Addcounsel is … (AI summary)
Responded
Michael Spencer
Concerns: The coroner raised concerns regarding the non-availability of Andexanet alfa, a reversal agent for Factor Xa inhibitor anticoagulants, in the UK, given the increasing clinical use of these drugs.
Overdue
William Abrahams
Concerns: The coroner raises concerns that the Abdominal Aortic Aneurysm (AAA) screening programme's age criteria excluded Mr Abrahams, and notes that the asymptomatic nature of AAAs makes the benefits of opting in unclear to patients.
Response (NHS England): • The response described past communication and engagement plans, including informing GP practices and holding public events to promote awareness and self-referral for eligible men. • NHS England London Region … (AI summary)
Responded
Danyon Chesters
Concerns: Delays in accessing NHS mental health services led the individual to private therapy, resulting in a lack of joined-up care and information sharing. Concerns were also raised that private therapists have no obligation to obtain information about medication prescribing.
Response (Department of Health and Social Care): • The Department committed to expanding Improving Access to Psychological Therapies (IAPT) services to increase access for an additional 600,000 people annually. • The Department confirmed an additional £2.3 billion … (AI summary)
Responded
Clive Rivers
Concerns: The coroner raised concerns that a vulnerable inpatient was not vaccinated for Covid-19 due to hospital policy and contracted the virus because of discharge delays. The discharge assessment framework did not adequately consider his vulnerability to rapid decline from Covid-19.
Response (NHS England): • NHS England stated that national guidance from December 2020 indicated inpatient COVID-19 vaccination could occur in line with JCVI guidance. • NHS England outlined the National Hospital Discharge policy … (AI summary)
Response (Department of Health Social Care): • Officials shared the report with the Care Quality Commission and the Healthcare Safety Investigation Branch to support intelligence monitoring of patient safety risks. • The NHS in Greater Manchester … (AI summary)
Responded
Neil Hickman
Concerns: K&C hospital did not measure ferritin levels in patients receiving frequent platelet transfusions, risking undetected iron overload. The coroner noted that even without funding for chelation therapy, patients could be referred or informed of private treatment options.
Response (Kent and Canterbury Hospital): • The hospital stated that all Myelodysplastic Syndrome patients undergoing frequent red cell transfusions and referred for a bone marrow transplant will have their ferritin levels measured. • This action … (AI summary)
Overdue
Amanda Hesketh
Concerns: The coroner noted a lack of systematic review and individual care plans for patients on repeat multiple analgesics within general practice, alongside difficulties in accessing specialist pain clinics due to long waiting lists. Concerns were also raised regarding GP practices not universally engaging practice pharmacists for patients with complex analgesia regimes.
Response (Department of Health and Social Care): • NHS England updated the Structured Medication Review (SMR) and medicines optimisation service in March 2022 to expand eligibility for patients on specific addictive medications, with implementation to be monitored. … (AI summary)
Response (Donneybrook Medical Centre): • The practice collaborated with the Medicines Optimisation Team to categorise patients on multiple analgesics by risk and urgency. • A plan was implemented to review patients on the red … (AI summary)
Responded
Gregor Lynn
Concerns: The cost of histological analysis in private treatment may deter patients from crucial diagnostic tests routinely included in NHS care. This disparity poses a risk of future deaths by hindering early cancer detection.
Response (Cambridgeshire and Peterborough): • The Integrated Care Board reviewed its current and previous referral policies for benign skin lesions. • It will signpost NHS GPs to guidance on skin cancer detection and remind … (AI summary)
Response (NHS England): • The Cambridgeshire and Peterborough Integrated Care System (ICS) reminded local GPs of guidance on skin cancers and shared their benign skin lesion policy. • The ICS reminded NHS primary … (AI summary)
Response (Department of Health and Social Care): • Departmental officials made enquiries with NHS England regarding the issues raised. • The response noted that NHS England had raised the concerns with the relevant Integrated Care System (ICS). … (AI summary)
Responded
Peter Fanning
Concerns: The coroner noted delays in replacing feeding tubes due to limited radiology list availability for complex patients, leading to suboptimal nutrition. There is also a need to consider how best to maintain patient nutrition after tube dislodgments.
Response (University Hospitals Birmingham NHS Foundation Trust): • The Interventional Radiology department increased capacity from one to four lists per week across Heartlands, Good Hope, and Solihull Hospital sites for x-ray guided feeding tube insertions. • The … (AI summary)
Responded
Select committee recommendations(38)
#19 —
Recommendation: The Government should work with industry to explore options for expanding these schemes during cost of living challenges to help wider groups at risk of digital exclusion.
Response attribution not verified
#18 —
Recommendation: We welcome the introduction of alternative voucher and discount schemes. These provide flexible ways to help people afford internet access.
Response attribution not verified
#17 —
Recommendation: We recommend Ofcom consults on requiring Openreach to offer a wholesale social tariff.
Response attribution not verified
#16 —
Recommendation: Removing VAT may not be enough to lower prices to an affordable level for those on the lowest incomes. Lowering the wholesale price floor for sales of social tariffs is one way to address this.
Response attribution not verified
#15 —
Recommendation: The Government should remove VAT from retail social tariffs and from the wholesale broadband used to provide them. The Government must then work with Ofcom to monitor social tariff prices to ensure these savings are passed on to consumers.
Response attribution not verified
#14 —
Recommendation: Most social tariffs are still too expensive for the most financially vulnerable.
Response attribution not verified
#2 —
Recommendation: Cost of living challenges have made a bad situation worse for people who struggle to afford internet access. The need for Government action is becoming increasingly urgent. (Paragraph 32) The case for intervention
Response attribution not verified
#4 — Review NHSE payment systems and processes to incentivise local systems supporting hard-to-reach patients.
Recommendation: In some cases, NHSE’s payment mechanisms can mean that local systems do not receive financial recognition when they prioritise hard-to-reach patients. GP surgeries receive a payment for every child vaccination. This vaccination funding mechanism favours areas where parents are more …
Response attribution not verified
#119 — Cash remains essential for vulnerable groups, as digital solutions may not ensure full financial inclusion.
Recommendation: Cash is an enduring payment method that many people prefer to use and on which people who do not have equal access to non-cash payment methods rely. Although technology may progress further and reduce the number of people who rely …
Response attribution not verified
#20 — Provide free over-the-counter medication for low-income patients through Pharmacy First scheme.
Recommendation: To avoid patients continuing to use GPs for support that could be offered in a community pharmacy setting because of concerns about the affordability of over-the- counter medication, we recommend that such medication is free for people on low incomes, …
Response attribution not verified
#13 —
Recommendation: We urge internet providers to do more to increase social tariff uptake and review whether their current promotional strategies are delivering results. Ofcom should provide a clearer expectation of what constitutes a social tariff and work with providers, consumer organisations …
Response attribution not verified
#20 —
Recommendation: We were concerned that some energy customers have been disproportionately affected by the energy crisis. For example, we noted that some vulnerable customers rely on prepayment meters but it costs more to administer the cost of energy paid by prepayment …
Response attribution not verified
#5 —
Recommendation: It is unacceptable that many vulnerable customers, on top of having to pay higher energy prices, face extra challenges working with energy suppliers and accessing benefits designed to help people with their energy bills. Vulnerable customers are most exposed to …
Response attribution not verified
#8 —
Recommendation: We do not support a paywall for domestic audiences to watch older content on iPlayer. This would make it more difficult for the BBC to deliver a universal service. However, we agree that there is potential for the BBC to …
#12 —
Recommendation: We welcome recent improvements in the availability and awareness of social tariffs. But take up stands at just five per cent.
Response attribution not verified
#1 —
Recommendation: Digital exclusion remains a serious problem. Although there has been progress in recent years, millions of people still cannot access the internet or use it adequately. For some, skills and motivation are the main barriers. For others, affordability is the …
Response attribution not verified
#22 —
Recommendation: The National Audit Office (NAO) report found that consumers in otherwise similar vulnerable circumstances can experience very different outcomes depending on who their provider is. While the average social tariff discount amounted to 55% of average household water bills in …
#21 —
Recommendation: There are inconsistencies in the eligibility criteria for supporting consumers in vulnerable circumstances. In water, the Department for Environment, Food & Rural Affairs (Defra) issues guidance setting the framework within which all water companies offer social tariffs to low-income households.59 …
#20 —
Recommendation: Each regulator has its own definition of vulnerability, including financial vulnerability.56 Martin Lewis told us that regulators could be doing more to define who should and shouldn’t be protected in such circumstances.57 For example, in markets with competition, regulators promote …
#19 —
Recommendation: Defining vulnerable circumstances is complex, but essential to ensuring that people needing support are identified and that support is tailored to their specific needs. People can move in and out of vulnerabilities on a temporary basis, for example becoming financially …
#14 —
Recommendation: There are no PSR arrangements in telecoms. Instead, Ofcom requires companies to give consideration to services for people in vulnerable circumstances, and to register customers based on needs.39 In 2024, the overall satisfaction for customers with a limiting condition was …
#12 —
Recommendation: Martin Lewis told us that, as with social tariffs, the system places the burden on people in vulnerable circumstances to declare those circumstances to companies and to ask for support.33 CCW told us that, for those consumers who are aware, …
#11 —
Recommendation: In the energy and water sectors, companies maintain the Priority Services Register (PSR) to provide support to customers with additional communication, safety and access needs.28 Ofgem and Ofwat have encouraged companies in their sectors to increase take-up of the PSR …
#10 —
Recommendation: Martin Lewis told us that differing social tariff levels also make it difficult for consumers in financially vulnerable circumstances to compare companies’ offers and identify the best deals for themselves.25 Social tariffs are not always visible on Ofcom-accredited price comparison …
#2 —
Recommendation: The current system relies too heavily on customers in vulnerable circumstances being willing and able to repeat personal information to multiple companies. In energy and water, companies maintain the 3 Priority Services Register (PSR) to provide support to customers with …
#1 —
Recommendation: Awareness and take-up of social tariffs is low, meaning millions of eligible customers are missing out on financial support. Ofwat and Ofcom have encouraged companies in water and broadband respectively to offer social tariffs to customers on lower incomes. Take-up …
#35 —
Recommendation: Remote advice can help extend provision, but it cannot be treated as a complete substitute for local face-to-face services, particularly for digitally excluded or vulnerable clients and for cases involving court proceedings. (Conclusion, Paragraph 108)
Response status not verified
#21 —
Recommendation: We asked Ofgem what it was doing to support vulnerable customers. Some stakeholders criticised Ofgem’s decision to add the SOLR cost levy to the electricity standing charge when customers cannot influence this cost by reducing their energy usage. Ofgem told …
Response attribution not verified
#3 —
Recommendation: We also recommend that the Department then needs to redesign the financial incentives in the healthcare system so that local authorities do not seek to ‘offload’ autistic people and people with learning disabilities onto the NHS or place these individuals …
Gov response: We accept this recommendation in full. We agree that there must be credible alternatives so that people live independent, free, and fulfilled lives in their community, and there must not be any financial incentives or …
Accepted
#23 — Free' specialised devices create perverse financial incentives, conflicting with clinical judgement.
Recommendation: NHSE described how it has established an evidence base for which specialised products are best to use (formerly known as high cost tariff excluded devices and now known as the Specialised Services Devices Programme). NHSE explained in written evidence that …
Response attribution not verified
#29 — NHS England made £1.3 million ineligible payments to suspended practitioners, with minimal recovery.
Recommendation: NHS England can make payments to medical practitioners who have been suspended, in accordance with the relevant statutory regulations and conditions. The C&AG qualified his opinion on NHS England’s accounts for the second time, as a result of it making …
Response attribution not verified
#6 — Implement planned changes to control framework to prevent further ineligible payments by summer 2024.
Recommendation: NHS England again made payments to suspended GPs who were not eligible to receive them and has failed to adequately recover these overpayments. NHS England has made overpayments worth £1.3 million to suspended medical practitioners since 2017–18, just £33,000 of …
Response attribution not verified
#16 —
Recommendation: There are 6 million people on the waiting list for elective care.36 NHSE&I told us it intends to focus on those with the highest clinical need and priority, and especially in the immediate period, those who have waited the longest …
Response attribution not verified
#1 —
Recommendation: We welcome the changes to the process for accessing benefits via the special rules for terminal illness, specifically replacing the six month rule with 12 months.
Response attribution not verified
#31 — NHS England faces challenges in fully recovering identified overpayments from 2022-23.
Recommendation: We asked NHS England whether it was pursuing recovery of the overpaid amounts identified in 2022–23. NHS England told us that it was still seeking to recover more of the overpayments, but that it did not think that it would …
Response attribution not verified
#30 — NHS England establishing a national team to enhance controls over suspension payments.
Recommendation: We asked NHS England why it did not have adequate controls in place to prevent ineligible payments of this nature and what controls it was putting in place to ensure that this does not happen again. NHS England confirmed that …
Response attribution not verified
#32 — Develop solutions to counter school incentives biasing pupils towards academic routes.
Recommendation: The Department should develop potential solutions to the problem of schools being incentivised to encourage pupils to follow academic routes. As a first step, it must ensure that Ofsted are giving appropriate weight to employment and vocational routes when looking …
Response attribution not verified
#30 — Schools are incentivised to bias pupils towards academic routes over vocational pathways.
Recommendation: Simply informing pupils of the options available is not enough to tackle the fundamental bias towards academic routes still seen in many schools. As long as 52 Careers Education, Information, Advice and Guidance schools are incentivised to steer pupils towards …
Response attribution not verified
NAO audit recommendations(9)
NHS financial management and sustainability
The Department and NHSE&I should develop a coherent long-term capital strategy, based on a long-term capital settlement, to support the development of The NHS Long Term Plan. This should include establishing a transparent, simplified, needs-based mechanism for prioritising, accessing and …
Accepted
NHS financial management and sustainability
The Department and NHSE&I should develop a better understanding of how much of the deficits in trusts in severe financial difficulties are down to structural issues that cannot be addressed by local health systems and develop a plan to address …
Accepted
NHS financial management and sustainability
As part of these wider financial reforms to establish a more stable funding system, the Department should put in place an alternative support system to provide assistance to the most financially distressed organisations, stop issuing loans where there is no …
Accepted
NHS financial management and sustainability
The Department and NHSE&I should redesign the financial architecture to promote the behaviours that will be needed to achieve The NHS Long Term Plan. It should draw on the lessons from previous schemes which have not worked, such as the …
Accepted
The Restart scheme for long‑term unemployed people
f) continuously improve its use of Payment by Results using its open book accounting provisions. It should review the incentives in its payment by result contracts and seek to refine these for future programmes, to reduce the extent to which …
Partially accepted
Introducing Integrated Care Systems: joining up local services to improve health outcomes
c) by April 2023, NHSE should set out plans to identify unavoidable cost differences in the provision of healthcare by different trusts and take account of them in the formula for allocating funding to ICBs. This should include a timetable …
Accepted
The energy supplier market
c) undertake a review of the costs and benefits of the price cap to inform decisions about the operation of the cap and alternative forms of price protection. This should include consideration of whether alternative types of price cap, such …
Accepted
Support for pupils with special educational needs and disabilities in England
The Department should review the incentives in the funding arrangements and the accountability system, and make changes that encourage and support mainstream schools to be more inclusive in terms of admitting, retaining and meeting the needs of pupils with SEND, …
Accepted
Investigation into NHS Property Services Limited
The Department and national bodies should: c) examine ways to encourage occupiers and local health economies to take greater ownership of paying for the Service’s estate.
Accepted
Health investigations(2)
An independent external quality assurance review of the independent investigation … — Rec 8
The Trust must ensure that an appropriate prescribing plan is developed and implemented when patients are at risk of becoming homeless or not registered with a GP.
north_west
Independent investigation: Angela Titley, Private Psych hospital, Redhill, Surrey (2004) — Rec R12
We recommend to PCTs, Trusts and Social Services that it should be re-emphasised to those involved in making recommendations for placements for psychiatric patients that the primary concern must always be the patient’s individual needs, rather than financial considerations.
south_east
Independent reviews(8)
Wanless Review — Rec 18
As an early step down this road towards better engagement of patients in thinking about the health service, there may be an argument for charging for missed appointments (6.89).
Health & Social Care
Wanless Review — Rec 14
There is an argument for extending out-of-pocket payments for non-clinical services and recommends that they should be kept under review (6.76).
Health & Social Care
Wanless Review — Rec 13
The present structure of exemptions for prescription charges is not logical, nor rooted in the principles of the NHS. If related issues are being considered in future, it is recommended that the opportunity should be taken to think through the rationale for the exemption policy (6.75).
Health & Social Care
Dilnot Commission — Rec 5
People should contribute a standard amount to cover their general living costs, such as food and accommodation, in residential care. We believe a figure in the range of £7,000 to £10,000 a year is appropriate.
Health & Social Care
Dilnot Commission — Rec 2
Not everyone will be able to afford to make their personal contribution, and those currently just outside the eligibility for means-tested help are not adequately protected. To address this, means-tested support should continue for those of lower means, and the asset threshold for those in residential care beyond which no …
Health & Social Care
Timpson Review — Rec 15
DfE should look carefully at the timing and amounts of any adjustments to schools' funding following exclusion, to make sure they neither act as an incentive for schools to permanently exclude a pupil at particular times, nor discourage a school from admitting a child who has been permanently excluded from …
Education
Accepted
MacAlister Review — Rec 55
Integrated Care Boards should publish their plans for improving the mental and physical health of those in care and leaving care and routinely publish progress. As part of these plans and new corporate parenting responsibilities, the Department of Health and Social Care and the NHS should exempt care leavers from …
Education
Roberts Review (STEM) — Rec 3.5
While student debt does not in general appear to be deterring potential students from undergraduate education, at the margin some undergraduates may be deterred from science and engineering courses, as they involve longer hours than other courses and as a result students find it more difficult to supplement their income …
Education
PHSO casework decisions(71)
P-004778 — The Dudley Group NHS Foundation Trust
Mrs E complained the Trust stopped her podiatry treatment, offered no alternatives, and this caused pain, reduced mobility, and decline in mental health.
NHS in England
Feb 2026
P-001129 — University Hospitals Birmingham NHS Foundation Trust
Mr E complained the Trust charged his mother over £6,000 for care after initially quoting £900, causing shock and financial difficulty.
NHS in England
Oct 2021
P-001579 — NHS Surrey Heartlands
Mr N complained the CCG failed to provide continuing healthcare funding for Mrs N between October 2019 and April 2020, requiring his family to fund her care.
NHS in England
Oct 2022
P-003246 — NHS England
Mr A complained NHS England's independent review panel wrongly upheld a decision that his late mother was not eligible for NHS funded continuing healthcare (CHC).
NHS in England
Dec 2024
P-003226 — NHS England - South - South East (Local …
Ms R complained NHS England's review panel wrongly decided her late mother was ineligible for NHS continuing healthcare, alleging insufficient consideration of her needs and procedural errors.
NHS in England
Dec 2024
P-003292 — University Hospitals Plymouth NHS Trust
Dr Y complained the Trust failed to inform him that his son's care became chargeable as an overseas patient, leading to a backdated payment request of over £9,000.
NHS in England
Not Upheld
Jan 2025
P-004412 — Royal Devon University Healthcare NHS Foundation Trust
Mrs A complained the Trust incorrectly charged her mother for Acute Healthcare At Home care without consent, causing her significant stress during pregnancy.
NHS in England
Dec 2025
P-004669 — NHS England
Mrs L complained NHS England's independent review panel incorrectly upheld the decision that her husband was ineligible for NHS continuing healthcare (CHC) funding, disagreeing with the assessment.
NHS in England
Jan 2026
P-004671 — Lancashire and South Cumbria Integrated Care Board
Mr Q complained the ICB refused a retrospective review of his late mother's care, used an incorrect document for her DST, and failed to provide an outcome letter, denying appeal rights.
NHS in England
Jan 2026
P-001145 — Nottingham and Nottinghamshire CCG
Mr M complained the CCG wrongly changed criteria and declined his funding request for epidural injections, alleging a staff member was misrepresented in the complaint response.
NHS in England
Oct 2021
P-001163 — Cambridgeshire and Peterborough CCG
Mr E complained the CCG wrongly refused to fund his lipoma removal, alleging it ignored exceptional criteria, pain, and size, and that the decision was discriminatory and resource-driven.
NHS in England
Oct 2021
P-003055 — Department for Work and Pensions
Mr A complained the DWP failed to pay the correct amount of rent through an Alternative Payment Arrangement since August 2021, resulting in financial disadvantage and frustration.
UK Government
Oct 2024
P-001769 — Royal Berkshire NHS Foundation Trust
Dr R complained the Trust failed to confirm NHS funding for his wife's fertility treatment, retrospectively billing her and then using intimidating tactics for payment.
NHS in England
Jan 2023
P-003876 — Barts Health NHS Trust
Ms I complained the Trust unfairly charged her for urgent S-ICD treatment and stopped home monitoring, alleging she was not a UK resident entitled to free NHS care.
NHS in England
Sep 2023
P-002470 — Guy's and St Thomas' NHS Foundation Trust
Mrs Y complained the Trust refused funding for a dental implant, despite previous dental repair funding, causing distress and difficulty eating.
NHS in England
Feb 2024
P-002821 — Hertfordshire and West Essex Integrated Care Board
Ms O complained the ICB agreed to refund nursing fees for her mother but then refused payment, impacting her mother's estate.
NHS in England
Jul 2024
P-003013 — NHS England
NHS England's review panel wrongly upheld Mrs T's ineligibility for CHC funding, causing family to pay for care. ICB poorly handled concerns about unpaid backdated fees and accused complainant of unreasonable behaviour.
NHS in England
Oct 2024
P-004099 — NHS England
Mr Y complained NHS England's independent review panel wrongly upheld the ICB's decision that his wife was not eligible for continuing healthcare funding.
NHS in England
Sep 2025
P-001285 — A medical practice in the Warwickshire area
Mr A complained the Practice failed to provide promised diabetic testing strips and incorrectly recorded his diabetes type as 2 instead of 1.
NHS in England
Jan 2022
P-001520 — Nottingham and Nottinghamshire Integrated Care Board
Mr P complained the ICB refused to retrospectively assess Mrs Y for continuing healthcare funding, alleging an incorrect checklist and missed assessment.
NHS in England
Aug 2022
P-001573 — NHS England
Mr U complained NHS England's Independent Review Panel (IRP) wrongly upheld the decision that Mrs U was ineligible for CHC funding, citing improper consideration of records and her complex needs.
NHS in England
Oct 2022
P-001583 — Cambridgeshire and Peterborough Integrated Care System
Mrs A complained the ICS refused to refund the legal fees she incurred while pursuing the CHC appeals process, causing financial impact to her late mother's estate.
NHS in England
Oct 2022
P-001690 — NHS England
Mr O complained NHS England's IRP decision regarding Mr W's CHC eligibility was flawed, citing inadequate evidence review, unaddressed factual errors, and improper consideration of his needs.
NHS in England
Oct 2022
P-001835 — NHS England
Mrs L complained that NHS England's Independent Review Panel (IRP) wrongly upheld a decision denying her husband, Mr L, NHS Continuing Healthcare (CHC) funding, due to improper consideration of his needs.
NHS in England
Nov 2022
P-001736 — Integrated Care Northamptonshire
Mrs B complained the ICB refused to fund a Joelette bike for her daughter in October 2020, restricting her activities during shielding and causing mental distress.
NHS in England
Jan 2023
P-001838 — Suffolk and North East Essex Integrated Care Board
Mr O complained the ICB improperly handled Mrs O's CHC funding eligibility, refusing a full assessment and not involving him, leading to significant care home fees.
NHS in England
Jan 2023
P-001787 — Humber and North Yorkshire Integrated Care Board
A legal firm complained the ICB refused to complete a checklist/DST for Mrs A's Continuing Healthcare, denied an FNC appeal, and refused a previously unassessed period of care assessment.
NHS in England
Feb 2023
P-002040 — North Central London Integrated Care Board
Care Fee Recovery complained about the interest rate paid on retrospectively funded continuing healthcare fees for Mrs T and a missed full assessment.
NHS in England
Jun 2023
P-002366 — NHS England - South (regional office)
Mrs J complained NHS England wrongly denied her husband CHC funding, alleging the Independent Review Panel's report contained errors and did not follow the National Framework.
NHS in England
Dec 2023
P-002930 — NHS Surrey Heartlands
Mr U complained NHS Surrey Heartlands ICB refused to provide a T:slim insulin pump, which he clinically needed, affecting his glucose control, education, and causing stress.
NHS in England
Sep 2024
P-003333 — A dental practice in the Blackburn area
Mrs F complained about poorly fitting NHS dentures and the dental practice refusing to replace them on the NHS, insisting on private treatment, and ignoring her letter about eating difficulties.
NHS in England
Feb 2025
P-003368 — NHS England
NHS England's independent review panel wrongly denied Mrs A Continuing Healthcare funding, forcing her to pay for care between January and October 2021.
NHS in England
Feb 2025
P-003926 — NHS England Midlands and East
Mrs O complained NHS England's independent review panel did not properly consider her mother's needs for continuing healthcare funding, nor procedural errors by the local integrated care board.
NHS in England
Sep 2025
P-004005 — NHS England
Mr K complained NHS England's independent review panel wrongly upheld a decision that his mother was not eligible for NHS continuing healthcare (CHC) funding, due to improper consideration of needs and procedural mistakes.
NHS in England
Sep 2025
P-004374 — University Hospitals of Leicester NHS Trust
Mr S complained he was charged £17,964 for his newborn son's heart surgery without prior notification. This caused financial hardship and emotional distress.
NHS in England
Nov 2025
P-004417 — Lincolnshire Integrated Care Board
Mr L complained the ICB incorrectly declined two funding requests for a vasectomy reversal, causing him severe pain, inability to work, financial loss, stress, and suicidal ideation until he paid privately.
NHS in England
Nov 2025
P-004471 — Salisbury NHS Foundation Trust
Dr D complains the Trust did not admit him for acute breathing difficulties and potential heart failure needing a pacemaker, forcing him to pay over £6,050 for private treatment.
NHS in England
Dec 2025
P-004544 — The Dudley Group NHS Foundation Trust
Ms A complained about The Dudley Group NHS Foundation Trust wrongly charging her £530 for an emergency department visit, alleging discrimination due to her health condition.
NHS in England
Dec 2025
P-004705 — NHS England
Mr E complained NHS England's review panel wrongly upheld a decision denying his mother NHS continuing healthcare funding, disputing the assessment of her needs.
NHS in England
Jan 2026
P-004711 — Mersey and West Lancashire Teaching Hospitals NHS Trust
Mr A complained about delays in receiving hip injections and arranging surgery for his stage four arthritis, leading to extreme, constant pain and worsened mental health.
NHS in England
Jan 2026
P-001161 — NHS England - North (regional office)
Mr D complained NHSE wrongly upheld a decision denying his mother CHC funding, disputing assessment criteria. He also criticised the IRP's unprofessional conduct.
NHS in England
Oct 2021
P-001188 — NHS England - North (regional office)
Mrs U complained NHS England's Independent Review Panel incorrectly assessed her mother's eligibility for NHS Continuing Healthcare, specifically regarding domain levels and key indicators.
NHS in England
Nov 2021
P-001201 — NHS England - North - Lancashire and Greater …
Mrs T complained NHS England's Independent Review Panel wrongly upheld her mother's ineligibility for NHS Continuing Healthcare, disagreeing with the assessment and suffering distress from the process length.
NHS in England
Nov 2021
P-001206 — NHS England - Midlands and East (regional office)
Mrs N and Mrs O complained NHS England's Independent Review Panel (IRP) wrongly found their mother ineligible for NHS Continuing Healthcare, disputing criteria applied and the IRP's decision-making process.
NHS in England
Not Upheld
Nov 2021
P-001235 — Northamptonshire Clinical Commissioning Group
Mrs I complained Northamptonshire CCG refused to reimburse her for eight days of post-death care home fees for her late husband, despite his eligibility for CHC funding.
NHS in England
Upheld
Dec 2021
P-001228 — NHS England and Northern, Eastern and Western Devon …
Mr R complained NHS England's review panel incorrectly upheld the CCG's decision that his late wife was ineligible for NHS continuing healthcare, misapplying assessment criteria.
NHS in England
Dec 2021
P-001234 — NHS England
Mr O complained NHS England incorrectly decided his father was ineligible for NHS continuing healthcare funding and refused a full Independent Review Panel.
NHS in England
Dec 2021
P-001328 — Bath and North East Somerset Swindon and Wiltshire …
Mrs H complained the CCG refused to fund her breast implant replacement surgery, despite a previous NHS commitment, causing her pain and significant financial burden due to a policy change.
NHS in England
Mar 2022
P-001649 — Cambridgeshire and Peterborough Integrated Care System
The ICS declined a referral for skin removal surgery, stating the case was not exceptional and psychological issues were insufficient reasons for funding.
NHS in England
Dec 2022
P-001398 — Department for Work & Pensions
Mrs O complained DWP failed to consider her terminally ill husband's health when pursuing a Pension Credit overpayment and denied his appeal rights. She also suffered stress from debt management.
UK Government
Partly Upheld
May 2022
LGO / SPSO decisions(231)
23-012-780 — Kent County Council
Summary: Ms F complained that her mother was wrongly charged a contribution to her residential care fees from 2002 to 2021 when she was entitled to free mental health aftercare. She also complained that the Council had not explained how it had calculated the refund or whether it had included …
LGO (Local Government & …
Adult Care Services
Upheld
Jul 2024
21-004-194 — Stockport Metropolitan Borough Council
Summary: The Council was at fault, because it did not offer the complainant’s mother an affordable care home placement, before asking her to pay a top-up towards her mother’s fees. This meant the top-up arrangement did not adhere with the statutory guidance. The Council has agreed to remedy the injustice …
LGO (Local Government & …
Adult Care Services
Upheld
Mar 2022
21-012-692 — Trafford Council
Summary: Mr X complained about the Council’s failure to tell him he had to make a financial contribution towards the cost of his care at home. He also complained about being charged for care he did not receive. We have found the Council to be at fault because it sent …
LGO (Local Government & …
Adult Care Services
Upheld
Jul 2022
21-011-082a — NHS Sussex Integrated Care Board (21 011 082a)
Summary: Ms D complains the Council and NHS Sussex refuse to pay for the full cost of her mother, Ms M’s, mental health aftercare. We have upheld the complaint and recommended remedies for Ms M and service improvements for the organisations. The Council and NHS Sussex accept our recommendations, so …
LGO (Local Government & …
Health
Upheld
Sep 2022
21-011-082 — East Sussex County Council
Summary: Ms D complains the Council and NHS Sussex refuse to pay for the full cost of her mother, Ms M’s, mental health aftercare. We have upheld the complaint and recommended remedies for Ms M and service improvements for the organisations. The Council and NHS Sussex accept our recommendations, so …
LGO (Local Government & …
Adult Care Services
Upheld
Sep 2022
22-006-241 — London Borough of Sutton
Summary: The Council did not compel Mr X to accept care or tell him there was a compulsory care order. The Council recognises it could have taken a decision sooner about Mr X’s capacity to make his own decisions about his care and offers to credit some months of care …
LGO (Local Government & …
Adult Care Services
Upheld
Dec 2022
23-014-091 — West Sussex County Council
Summary: Mrs X complained about the Council’s decision to charge her mother, Mrs Y, for her care and support, after first saying there would be nothing to pay. We did not find the Council said Mrs Y would not have to pay for her care and support. However, we found …
LGO (Local Government & …
Adult Care Services
Upheld
Jul 2024
24-005-784 — Dorset Council
Summary: We will not investigate Mrs X’s complaint that the Council’s financial assessment was wrong. There is not enough evidence of fault to justify an investigation.
LGO (Local Government & …
Adult Care Services
Sep 2024
24-021-990 — West Sussex County Council
Summary: We will not investigate this complaint about failure to complete the checklist for NHS continuing healthcare funding. We have no powers to investigate NHS matters, so cannot achieve the wanted result of backdated NHS funding. It is also unlikely we would find enough evidence of fault in the Council’s …
LGO (Local Government & …
Adult Care Services
Jun 2025
24-001-073 — London Borough of Haringey
Summary: the Council delayed in carrying out a financial assessment and then failed to take Ms X’s needs into consideration when it sent her forms to complete. The Council’s error in chasing a debt which was already paid caused additional stress and anxiety. The Council will now apologise to Ms …
LGO (Local Government & …
Adult Care Services
Upheld
Dec 2024
24-012-182 — Kingston Upon Hull City Council
on the lessons that can be learnt from our complaints about end of life care given in care homes and in the home.
LGO (Local Government & …
Adult Care Services
Upheld
Feb 2026
25-003-724 — Pressbeau Ltd
Summary: We will not investigate this complaint about how the Care Provider treated Funded Nursing Care in relation to care charges. Any injustice is not significant enough to justify our involvement.
LGO (Local Government & …
Adult Care Services
Jan 2026
24-021-599 — Rochdale Metropolitan Borough Council
Summary: Mr X complained the Council failed to provide his parents’ care and support plans, initially said the care costs would be minimal then charged more than £4000, and had poor communication when he raised concerns. He said this caused huge stress and worry to him and his parents, and …
LGO (Local Government & …
Adult Care Services
Upheld
Jan 2026
21-005-322 — Dorset Council
Summary: Mrs X complained about the Council’s handling of her father’s financial assessment in December 2020. There was fault in the way the Council decided that gifts to great grandchildren amounted to a deprivation of assets and it will reconsider that decision. There was also an initial failure to explain …
LGO (Local Government & …
Adult Care Services
Upheld
Jan 2022
21-000-911 — Lincolnshire County Council
Summary: Ms X complains the Council was at fault as it did not communicate her mother, Mrs Y would be required to contribute towards a domiciliary care service. The Council has accepted it was at fault. It has apologised and offered to withdraw the invoice for the charges incurred. This …
LGO (Local Government & …
Adult Care Services
Upheld
Jan 2022
21-000-261 — Essex County Council
Summary: the complainant, Ms X complained the Council failed to honour its commitment to fund her mother’s care in a care home the Council arranged for the family. This led to the family incurring a large debt. The Council said it provided the family with full details of the charges, …
LGO (Local Government & …
Adult Care Services
Upheld
Jan 2022
20-005-997 — Conifers Care Homes Ltd
Summary: Mrs X complains the Care Provider failed to reduce her late mother’s care fees when it successfully applied for Funded Nursing Care contributions. The Care Provider said it did not charge for services covered by the Funded Nursing Care contribution and so it has not overcharged for its services. …
LGO (Local Government & …
Adult Care Services
Upheld
Feb 2022
21-017-364a — Birmingham Community Healthcare NHS Trust (21 017 364a)
Summary: We will not investigate a complaint about the Trust not being clear with Mrs N about Mrs O’s diagnosis and the refusal by the Council to pay for care fees. Mrs N wants compensation, and it is reasonable for her to pursue this by making a legal claim against …
LGO (Local Government & …
Health
Apr 2022
21-010-785 — Staffordshire County Council
Summary: We will not investigate this complaint about care fees. There is insufficient evidence of fault with how the Council calculated the fees originally. The Council’s mistake to correctly apply the increased fees benefitted Mr X for 4 years. The Council is no longer pursuing the backdated fees. Any fault …
LGO (Local Government & …
Adult Care Services
Upheld
Apr 2022
20-013-004 — Hampshire County Council
stop payments, and that it has not reviewed Mr B’s needs. The Council is at fault because it did not try to contact Mr B’s representatives as it should have done, it stopped payments without ensuring Mr B’s care needs were still met and has delayed reviewing Mr B’s needs. …
LGO (Local Government & …
Adult Care Services
Upheld
Apr 2022
21-014-642 — Lincolnshire County Council
Summary: The Council was at fault, as it invoiced for more hours of care than were provided for several reasons. The Council has credited the service user for the hours of care that were not provided and this is a satisfactory remedy to the complaint.
LGO (Local Government & …
Adult Care Services
Upheld
May 2022
22-002-717 — London Borough of Hillingdon
Summary: We will not investigate Ms B’s complaint about money she says the Council owes her late mother’s, Mrs D’s, estate. This is because the Council has now considered the complaint and reimbursed Mrs D’s estate with monies owed. The injustice caused by the fault has now been remedied.
LGO (Local Government & …
Adult Care Services
Upheld
Jul 2022
21-017-426 — Blackpool Borough Council
Summary: Ms B complained on behalf of her mother, Mrs X, that the Council failed to send deferred payment agreement forms after she moved into residential care and failed to advise her that she could claim Attendance Allowance. We found the Council delayed in sending the deferred payment agreement form …
LGO (Local Government & …
Adult Care Services
Upheld
Jul 2022
21-006-380 — RBL Field House Care Ltd
Summary: Ms D complained the care provider increased the charges for her mother’s care without following the process set down in the contract. And that the increase was not justified. She said that as a result Ms X was charged too much and was threatened with eviction when they did …
LGO (Local Government & …
Adult Care Services
Upheld
Jul 2022
22-006-453 — Southampton City Council
Summary: Mr X complained the Council wrongly declined his application for a toll bridge fee exemption. He said the Council did not consider his application as someone with a mental health disability in the same way as it would consider an application from a person with a physical disability. Mr …
LGO (Local Government & …
Adult Care Services
Upheld
Nov 2022
23-019-120 — Warrington Council
Summary: We will not investigate Ms X’s complaint about the Council’s decision that the setting up of a family trust amounted to a deprivation of assets. The Council has agreed to make a payment to recognise the uncertainty caused by its delay in making the decision. There is insufficient evidence …
LGO (Local Government & …
Adult Care Services
Upheld
May 2024
23-005-398 — Sefton Metropolitan Borough Council
Summary: Mrs X complained about how the Council funded her father, Mr Y’s, mental health aftercare. There was some fault in how the Council made its decision not to backdate Mr Y’s personal budget in 2022, but this did not affect the outcome. However, the Council also failed to take …
LGO (Local Government & …
Adult Care Services
Upheld
May 2024
23-011-946 — Cambridgeshire County Council
Mrs C complained her family was not properly advised about the charges involved in securing a placement for her mother in a residential care home.
LGO (Local Government & …
Adult Care Services
Upheld
May 2024
24-000-844 — Staffordshire County Council
Summary: We will not investigate this complaint about the Council’s decision to not reimburse the complainant for alleged overpayments his family made in meeting his late mother’s care needs. This is because the complaint concerns historical events since 2010 and is therefore late. The passage of time means there is …
LGO (Local Government & …
Adult Care Services
May 2024
23-020-906 — Cornwall Council
Summary: We will not investigate Mr and Mrs X’s complaint about the lack of information about the costs of Mrs Y’s residential care. This is because the Council paid Mrs Y’s care fees initially, and later reduced the amount due for the chargeable days by £200, which is an appropriate …
LGO (Local Government & …
Adult Care Services
Upheld
Jun 2024
23-015-210 — London Borough of Havering
Summary: Mr X complains the Council failed to provide him and Ms Y with information about possible charges for her residential care leading to a debt causing distress. We have found no evidence of fault in the way the Council considered these matters. So, we have completed our investigation.
LGO (Local Government & …
Adult Care Services
Not Upheld
Aug 2024
23-019-863 — Royal Borough of Kingston upon Thames
Summary: We will not investigate Ms X’s complaint about the Council’s decision there was a deprivation of assets. This is because there is insufficient evidence of fault.
LGO (Local Government & …
Adult Care Services
Aug 2024
22-011-518-report — Coulson & Collins Care Home Ltd
The Local Government and Social Care Ombudsman investigated a complaint about Coulson & Collins Care Home Ltd. We found the care provider did not correctly record and refund an overpayment for the complainant’s late father’s care, incorrectly charged an administration fee, and delayed responding to her. It means her father’s …
LGO (Local Government & …
Adult Care Services
Upheld
Aug 2024
24-005-242 — Surrey County Council
Summary: We will not investigate Mr X’s complaint that the Council failed to tell him he might be charged for his care. The Council has waived some of the charges. An investigation would not lead to a different outcome.
LGO (Local Government & …
Adult Care Services
Upheld
Aug 2024
24-004-797 — Southampton City Council
Summary: We will not investigate this complaint about the Council including a home’s value in a financial assessment for social care charges. We cannot achieve more about the Council’s delay and its misdirecting Miss X to the wrong Council procedure. The Council properly reached its decision not to disregard the …
LGO (Local Government & …
Adult Care Services
Upheld
Aug 2024
24-005-281 — Royal Borough of Windsor and Maidenhead Council
Summary: We will not investigate Mrs X’s complaint about the Council’s refusal to pay her mother’s full care home fees and its decision that her mother can be safely moved to a cheaper care home. This is because the Council agreed to resolve the complaint early by providing a proportionate …
LGO (Local Government & …
Adult Care Services
Upheld
Sep 2024
24-001-518 — Cornwall Council
Summary: Mrs X said the Council’s handling of Mr X’s added care costs after he left hospital was unnecessarily time consuming, caused distress and significantly affected her finances. We found there was avoidable delay by the Council and a failure to properly process Mrs X’s complaint about the costs. To …
LGO (Local Government & …
Adult Care Services
Upheld
Sep 2024
23-019-512 — Manchester City Council
Summary: Mr X’s representative complained the Council wrongly charged him for a contribution to his residential care fees when he was entitled to free mental health aftercare. His representative also complained about how the Council calculated an interest refund payment on the amount Mr X paid. The Council has accepted …
LGO (Local Government & …
Adult Care Services
Upheld
Sep 2024
24-020-940 — East Sussex County Council
Summary: We will not investigate Mr X’s complaint about the Council’s charges for commissioned respite care for him and his wife Mrs X, and the information it gave about its charging. There is not enough evidence of fault by the Council to warrant an investigation.
LGO (Local Government & …
Adult Care Services
May 2025
24-020-473 — Luton Borough Council
Summary: We will not investigate Mr X’s complaint about the Council allowing his late sister to deal with his mother’s financial affairs even though she had special needs. This is because there is insufficient evidence of fault.
LGO (Local Government & …
Adult Care Services
May 2025
24-015-692 — Suffolk County Council
Summary: Mrs X complains about how the Council carried out financial assessments for her sons, Mr Y and Mr Z. Mrs X says this has resulted in them being charged for care. We find fault with the Council for its communication about charges, and its consideration of Mrs X’s complaint. …
LGO (Local Government & …
Adult Care Services
Upheld
May 2025
24-000-859 — Somerset Council
Summary: Mrs Z complained the Council has wrongly withdrawn Mrs Y’s care package, without properly considering how her needs will be met until her land can be sold. We found the Council’s decision to immediately end Mrs Y’s care package and seek to recover all costs incurred since April 2023 …
LGO (Local Government & …
Adult Care Services
Upheld
May 2025
25-002-654 — Blackpool Borough Council
We will not investigate this complaint about a care home commissioned by the Council charging additional fees to Mrs X. This is because the complaint is late and there are no good reasons to exercise discretion to investigate it. We also will not investigate the complaint about the Council not …
LGO (Local Government & …
Adult Care Services
Aug 2025
25-001-752 — Roseberry Care Centres (England) Ltd
Summary: We will not investigate this complaint about an increase in care home fees. There is not enough evidence of fault by the care provider.
LGO (Local Government & …
Adult Care Services
Oct 2025
24-023-411 — Norfolk County Council
Summary: There was no fault by the Council. The Council gave the correct advice on care funding on the information it received from the family before the care assessment was carried out and then carried out a financial assessment without fault. There was minor delay in carrying out the financial …
LGO (Local Government & …
Adult Care Services
Not Upheld
Nov 2025
25-007-934 — London Borough of Bromley
Summary: We will not investigate this late complaint about the Council’s charges for arranging a care service for Mrs X. There is not a good reason for the delay in complaining to the Council and then the Ombudsman about the matter.
LGO (Local Government & …
Adult Care Services
Nov 2025
24-020-403 — Redwood Tower UK Opco 2 Limited
Summary: Mrs X complained Avery Healthcare (the care provider) failed to promptly tell her of the fees payable and invoices for Mrs Y’s care when she became self-funding. She also complained the care home charged for care not needed or provided. Mrs X said the care home caused distress and …
LGO (Local Government & …
Adult Care Services
Upheld
Nov 2025
24-002-360 — Birmingham City Council
Summary: Ms X said the Council was not providing the property protection service Mr Z was paying for and its failure to do so might affect Mr Z’s ability to meet his care costs. We found fault in the Council’s service delivery but it did not cause Mr Z significant …
LGO (Local Government & …
Adult Care Services
Upheld
Oct 2024
24-001-994 — Midshires Care Limited
Summary: The care provider did not apply the contract terms properly and has now agreed to refund the relevant notice period. The care provider has also now apologised to Mrs X for its handling of this matter and offered a sum recognising the time, trouble and distress she was caused …
LGO (Local Government & …
Adult Care Services
Upheld
Nov 2024
24-009-444 — London Borough of Hillingdon
Summary: We will not investigate Mr X’s complaint about the Council’s delay in carrying out a financial reassessment for his mother, Mrs Y, after her husband died. This is because there is insufficient evidence of fault to justify our involvement.
LGO (Local Government & …
Adult Care Services
Nov 2024
Domestic Homicide Reviews(2)
Tewkesbury — recommendation 17.4.3
Review existing processes and guidelines where “housing debt” may be a barrier to a victim receiving appropriate support of obtaining a move to a safe environment and to ensure each case is given appropriate consideration.
Cheltenham Borough Homes
Northumberland — recommendation 3
That Northumberland County Council review the current written signposting to assistance for vulnerable residents with substantive Council Tax arrears and consider if that can be enhanced through direct contact with those residents and referral to support agencies, particularly when thresholds for recovery action are met.
Northumberland County Council
Northumberland County Council