Summary: Mr X complained that London Borough of Sutton (the Council), NHS South West London ICB (the ICB), and South West London and St George’s Mental Health NHS Trust (the Trust) failed to cover the costs of Ms Y’s prescriptions as part of Section 117 aftercare. We have upheld Mr X’s complaint about the ICB, because the ICB has agreed to take appropriate action to resolve matters. We will not investigate the complaint about the Council and the Trust as the ICB has accepted the delay.

The complaint

1. Mr X complains that NHS South West London Integrated Care Board (the ICB), London Borough of Sutton (the Council) and South West London and St George’s Mental Health NHS Trust (the Trust) failed to cover the cost of Ms Y’s prescriptions, which Mr X says should have been funded through Section 117 aftercare.
2. Mr X said this meant he and Ms Y had to pay for the prescriptions themselves. He also said that trying to resolve the issue caused him frustration and distress.
3. As an outcome of his complaint, Mr X seeks financial remedy for the distress caused.

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The Ombudsmen’s role and powers

4. The Local Government and Social Care Ombudsman and Health Service Ombudsman have the power to jointly consider complaints about health and social care. (Local Government Act 1974, section 33ZA, as amended, and Health Service Commissioners Act 1993, section 18ZA).
5. We investigate complaints about ‘maladministration’ and ‘service failure’. We use the word ‘fault’ to refer to these. If there has been fault, we consider whether it has caused injustice or hardship (Health Service Commissioners Act 1993, section 3(1) and Local Government Act 1974, sections 26(1) and 26A(1), as amended).

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How I considered this complaint

6. I considered evidence provided by Mr X, the ICB, the Council and the Trust, as well as relevant law, policy and guidance.
7. Mr X had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

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My assessment

8. Ms Y is entitled to Section 117 aftercare, which is arranged by the Council and ICB. Mr X understood that Ms Y’s prescriptions should be funded through Section 117 aftercare, and he contacted the Council, Trust and ICB asking them to arrange this. In 2024, Mr X also raised formal complaints with the organisations.
9. In responding to Mr X’s complaint, the ICB put arrangements in place for Ms Y’s prescriptions to be funded under Section 117 aftercare. In December 2025, the ICB also reimbursed Mr X for the prescription costs he had previously paid. The ICB apologised to Mr X and Ms Y for the delays.
10. If we investigated this complaint, it is likely we would find the ICB at fault because it has already accepted there was a delay in arranging payments for Ms Y’s prescriptions under Section 117 aftercare.
11. We therefore asked the ICB to consider remedying the injustice caused by making a symbolic payment of £300 to Mr X in recognition of the distress caused by the delay to resolve the complaint early.
12. To its credit, the ICB agreed to resolve the complaint and make a symbolic payment of £300 to Mr X within four weeks, in recognition of the distress caused to put things right.
13. We will not investigate Mr X’s complaint about the Trust and Council, as the ICB has accepted a delay in resolving the issue of the prescription costs.

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Decision

14. We have upheld Mr X’s complaint about the ICB. This is because the ICB has agreed to resolve the complaint early by providing a proportionate remedy for the injustice caused to Mr X.

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Investigator's decision on behalf of the Ombudsman