Assessment and funding


Recent statements in this category are shown below:

  • NHS Devon ICB (23 013 698a)

    Statement Closed after initial enquiries Assessment and funding 08-Feb-2024

    Summary: We will not investigate Mrs Y’s complaint that the ICB failed to pay interest when it refunded nursing home payments made by Mrs Y’s mother, Ms X. Mrs Y also complained the Council and the ICB’s communication about this was poor. During our consideration of the complaint, the ICB apologised, offered to pay interest to Ms X, and said it would improve services. The Council accepted shortcomings in how it handled Mrs Y’s enquiries about the payment, and it addressed this by apologising and providing staff training. The Council and ICB have provided a reasonable remedy to the complaint, and an investigation would be unlikely to add anything further for Mrs Y.

  • NHS England - South East Area Team (23 012 114a)

    Statement Closed after initial enquiries Assessment and funding 08-Jan-2024

    Summary: We will not investigate this complaint about a Council inappropriately seeking payment for care home fees. This is because it is unlikely an investigation would be able to provide an outcome the complainant would find satisfactory.

  • NHS Suffolk and North East Essex ICB (23 012 114b)

    Statement Closed after initial enquiries Assessment and funding 08-Jan-2024

    Summary: We will not investigate this complaint about a Council inappropriately seeking payment for care home fees. This is because it is unlikely an investigation would be able to provide an outcome the complainant would find satisfactory.

  • NHS North East and North Cumbria ICB (22 002 398c)

    Statement Not upheld Assessment and funding 22-Aug-2023

    Summary: Bentley Medical Practice most likely did not refer Mrs Y for fast-track continuing healthcare at the end of her life. Also, Shoreline Nursing Home’s record keeping was not in line with the relevant guidance. We do not know if Mrs Y would have been more comfortable before she died if not for that fault. Those organisations should take action to remedy the uncertainty that caused Mrs Y’s granddaughter, Mrs X.

  • NHS North East and North Cumbria ICB (22 002 398d)

    Statement Not upheld Assessment and funding 22-Aug-2023

    Summary: Bentley Medical Practice most likely did not refer Mrs Y for fast-track continuing healthcare at the end of her life. Also, Shoreline Nursing Home’s record keeping was not in line with the relevant guidance. We do not know if Mrs Y would have been more comfortable before she died if not for that fault. Those organisations should take action to remedy the uncertainty that caused Mrs Y’s granddaughter, Mrs X.

  • NHS Northamptonshire ICB (22 010 502a)

    Statement Upheld Assessment and funding 15-Aug-2023

    Summary: Mr X complained the Council and ICB gave him conflicting information about how his relative, Mrs Y’s, care should be funded, and did not review Mrs Y’s care needs. We found the Council and ICB failed to work together to decide how Mrs Y’s care should be funded, and the ICB did not review Mrs Y’s care needs. We found this caused uncertainty and avoidable distress to Mr X. The Council and ICB agreed to take action to remedy the injustice caused.

  • NHS North East and North Cumbria ICB (22 011 022a)

    Statement Upheld Assessment and funding 10-Aug-2023

    Summary: Mrs C complained about the care and support provided to her friend, Miss D, for whom she acts as an attorney. She complained about a lack of support and information sharing by the Integrated Care Board (ICB) when Miss D had to move from a residential care home to a nursing home. She said the Care Provider consistently failed to share information with her about Miss D’s care and support arrangements. She also complained about a top-up fee the Care Provider charged for the health-funded placement. We found fault in the way the ICB supported Mrs C when Miss D moved to the Care Provider’s nursing home. This likely caused Mrs C avoidable distress. We also found fault in the way the ICB and the Care Provider followed established guidance relating to care fees. This meant Miss D paid towards her care fees when the ICB was responsible for funding the placement. The ICB and the Care Provider have agreed to our recommendations and will apologise to Mrs C for the avoidable distress she experienced and arrange to reimburse her for the fees she paid on behalf of Miss D. The ICB and the Care Provider will act to improve their processes relating to top-up payment arrangements when a person’s nursing home placement is health funded.

  • NHS Norfolk and Waveney ICB (23 002 615a)

    Statement Closed after initial enquiries Assessment and funding 24-Jul-2023

    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.

  • NHS Lancashire and South Cumbria Integrated Care Board (22 015 902a)

    Statement Closed after initial enquiries Assessment and funding 05-Jun-2023

    Summary: We uphold Mrs X’s complaint about respite care provided to her late father, Mr Y. The Council accepted fault for not following Mr Y’s care plan, causing injustice to Mrs X and Mr Y, and has agreed to provide a financial remedy to Mrs X in view of the injustice it has already acknowledged. We will not investigate Mrs X’s complaint about the Trust, ICB and Council in relation to an assessment for NHS Continuing Healthcare. This is because it is unlikely we could add to the response already provided by the organisations.

  • University Hospitals of Morecambe Bay NHS Foundation Trust (22 015 902b)

    Statement Closed after initial enquiries Assessment and funding 05-Jun-2023

    Summary: We uphold Mrs X’s complaint about respite care provided to her late father, Mr Y. The Council accepted fault for not following Mr Y’s care plan, causing injustice to Mrs X and Mr Y, and has agreed to provide a financial remedy to Mrs X in view of the injustice it has already acknowledged. We will not investigate Mrs X’s complaint about the Trust, ICB and Council in relation to an assessment for NHS Continuing Healthcare. This is because it is unlikely we could add to the response already provided by the organisations.

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