Summary: We will not investigate a complaint by Mrs D about a change in funding by a Council and Integrated Care Board for her son, Mr E’s, joint package of care. The Council and Integrated Care Board has not reduced the care package so we would be unlikely to find a fault leading to a significant injustice to Mrs D and Mr E.

The complaint

1. Mrs D complains about a decision by Torbay Council (the Council) and NHS Devon Integrated Care Board (the ICB) to remove joint funding for her son, Mr E’s care.
2. Mrs D says the decision making process has not been clear or transparent, and she has not been given a right of appeal.
3. Mrs D said the process has left her confused and affected her ability to safeguard her son’s best interests
4. As a result of the complaint Mrs D would like a reinstatement of the health funding and a formal review of the decision-making process.
5. She also wants written confirmation of the steps that take place to ensure future reviews follow correct processes, transparency and clarity, fairness, specialist involvement, time and communication

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The Ombudsmen’s role and powers

6. We provide a free service, but must use public money carefully. We may decide not to start or continue with an investigation if we believe:

• it is unlikely we would find fault, or
• the fault has not caused injustice to the person who complained, or
• the injustice is not significant enough to justify our involvement, or
• we cannot achieve the outcome someone wants
  (Health Service Commissioners Act 1993, section 3(2) and Local Government Act 1974, section 24A(6), as amended)

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How I considered this complaint

7. I considered evidence provided by Mrs D, the Council and ICB as well as relevant law, policy and guidance.

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What I found

Background

8. Mr E has several health conditions and in 2025 was receiving a joint package of care funded by the Council and the ICB.
9. Mrs D said that in early 2025 a social worker informed her that the NHS component of the package had now been moved to the Council so that the package would now be completely Council funded.
10. Mrs D complained that she that the process was not transparent and she had not been given a right of appeal.
11. The Trust said that the Council and ICB had reviewed the package and decided that the needs Mr E had could be met by social care and so it transferred the package to the Council. It said that there was no material change to the package and the same amount of funding and support would remain in place.

Analysis

12. NHS guidance states neither the NHS nor the local authority should withdraw from an existing care or funding arrangement without a joint reassessment of needs, and without first consulting with one another, and with the patient, about any proposed change in arrangement, as well as ensuring that alternative funding or services are put into effect.
13. There is evidence that a review of Mr E’s needs took place with Mrs D, a social worker, an assistant practitioner from the Learning Disability Service and a Continuing Healthcare Nurse attending. An investigation would be unlikely to find that Mrs D was not consulted about the review of Mr E’s needs.
14. The decision may not have been communicated to the family properly as Mrs D said she did not receive any confirmation in writing. She said she received a draft decision and then a social worker informed her over the phone of the change.
15. This may be an indication of fault, however there is no injustice to Mr E because his package of care did not reduce in what it provided to him. Any frustration caused by a fault in communication would not be significant enough for it to be proportionate to investigate this complaint.
16. Mrs D said that she wanted to raise attention to the practice of joint packages being moved from health to social care and she feels this could be as health care is free and social care can sometimes be means tested and chargeable.
17. However, Mrs D has not been charged and the Council and NHS are entitled to change the package of care if they follow the correct process which they appear to have done in this case.

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Decision

18. I will not investigate this complaint as we would be unlikely to find fault causing injustice to Mrs D and Mr E.

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Investigator's decision on behalf of the Ombudsman