Summary: We will not investigate this complaint about interest payments related to a refund of NHS continuing healthcare funding. The complaint does not meet the tests in our Assessment Code on how we decide which complaints to investigate. The complaint is mostly against an NHS organisation and so more suitable for a different Ombudsman to consider. Even if we were to investigate the Council’s actions, we would be unlikely to achieve the result the complainant wants.

The complaint

1. I will call the complainant Mrs Z. Mrs Z complains that her husband did not get all the interest he should have, when he received a refund of care home fees that should have funded through the NHS. Mrs Z would like her husband to receive a larger interest payment from the NHS organisation.

Back to top

The Ombudsman’s role and powers

2. We investigate complaints about councils and certain other bodies. We cannot investigate the actions of bodies such as NHS organisations. (Local Government Act 1974, sections 25 and 34(1), as amended)
3. We investigate complaints about ‘maladministration’ and ‘service failure’, which we call ‘fault’. We must also consider whether any fault has had an adverse effect on the person making the complaint, which we call ‘injustice’. We provide a free service, but must use public money carefully. We do not start an investigation if we decide the tests set out in our Assessment Code are not met. This includes where we decide we cannot achieve the outcome someone wants. (Local Government Act 1974, section 24A(6), as amended)

Back to top

How I considered this complaint

4. I considered information provided by the complainant, the Council, the NHS organisation and the Parliamentary and Health Service Ombudsman (PHSO). I also discussed the complaint with Mrs Z.
5. I considered the Ombudsman’s Assessment Code.

Back to top

My analysis

6. Mrs Z complained to the Parliamentary and Health Service Ombudsman on Mr Z’s behalf about an NHS organisation’s decision not to fund Mr Z’s care home fees. The NHS organisation agreed to resolve this complaint by arranging a refund of the fees, which Mr Z had originally paid to the Council. The Council refunded the fees. The NHS organisation paid Mr Z interest on this amount.
7. Mrs Z considers the interest amount should have been greater and should have covered the entire period, up to the date the Council issued the care home refund. She does not consider the Council acted with delay, but rather that the NHS organisation’s end date for its interest payment was too early. She considers the NHS organisation has failed to comply with the remedy in PHSO’s decision.
8. For the reasons above, this complaint is mainly about the actions of the NHS organisation and something Mrs Z should ask PHSO to consider.
9. Even if we were to investigate the actions of the Council, it is unlikely that we would decide the Council had acted with fault causing an injustice it needs to remedy. This is because the information we already have indicates the Council refunded the sum it had been asked to refund, within about six weeks of being asked to do so. Our guidance on remedies says a financial remedy from the Council would not be appropriate in these circumstances. This means that investigating the Council's actions is unlikely to achieve the result Mrs Z seeks.

Back to top

Final decision

10. We will not investigate Mrs Z’s complaint because it is mainly about the actions of an NHS organisation. The Local Government and Social Care Ombudsman cannot investigate the actions of the NHS organisation. Any investigation of the Council’s actions is unlikely to achieve the result Mrs Z wants.

Back to top

Investigator's decision on behalf of the Ombudsman