Summary: We have found fault in the way the Council considered Miss X’s request for medical priority on the Housing Register. She cannot be satisfied that all the medical evidence she submitted was properly considered. The Council has agreed to apologise to Miss X and carry out a new review.

The complaint

1. Miss X complained that the Council:
• did not properly consider her request for Band 2 urgent medical priority on its Choice Homes scheme and the supporting evidence she submitted;
• wrongly moved her application from Band 3 to Band 4 and did not apologise for making this error;
• states she is not eligible when she bids for houses on the Choice Homes scheme which restricts her to bidding for flats.
2. Miss X and her son both have serious medical conditions. She says the lack of space in their current home has a significant impact on her mental health and on her son’s behaviour and sleep disorder.

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The Ombudsman’s role and powers

3. We investigate complaints about ‘maladministration’ and ‘service failure’. In this statement, I have used the word fault to refer to these. We must also consider whether any fault has had an adverse impact on the person making the complaint. I refer to this as ‘injustice’. If there has been fault which has caused an injustice, we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
4. If we are satisfied with an organisation’s actions or proposed actions, we can complete our investigation and issue a decision statement. (Local Government Act 1974, section 30(1B) and 34H(i), as amended)

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How I considered this complaint

5. I have spoken to Miss X and considered all the information she provided. I considered the Council’s housing allocations policy, its response to my written enquiries and relevant housing records.
6. Miss X and the Council made comments on a draft version of this decision, which I took into account.
7. Miss X has made previous complaints about the Council’s assessment of her housing application and priority. This investigation concerns the way the Council decided in September 2021 that she did not qualify for medical priority and its consideration of her request for a review of that decision. We have not investigated earlier decisions or decisions made after January 2022.

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What I found

The relevant law – housing allocations

8. Every local housing authority must publish an allocations scheme that sets out how it prioritises applicants, and its procedures for allocating housing.  All allocations must be made in strict accordance with the published scheme. (Housing Act 1996, section 166A(1) & (14))
9. An allocations scheme must give reasonable preference to applicants in the following categories:

• homeless people;
• people in insanitary, overcrowded or unsatisfactory housing;
• people who need to move on medical or welfare grounds;
• people who need to move to avoid hardship to themselves or others;
  (Housing Act 1996, section 166A(3))
   

10. Councils must notify an applicant in writing of a decision that they are not entitled to a reasonable preference. They must give reasons for the decision and notify the applicant of the right to request a review of the decision. (Housing Act 1996, section 166A(9))
     

Redbridge Council’s housing allocations scheme

11. The Council’s housing allocations scheme places applicants who qualify to join its Housing Register in one of four priority bands following an assessment of their housing needs:

Band 1 – emergency – tenants who must be moved urgently due to estate regeneration schemes; emergencies and management transfers; or an applicant who cannot be discharged from hospital due to not having suitable accommodation.

Band 2 – urgent – which includes an urgent need to move on medical grounds. This is defined as the applicant or household member having a serious medical condition which is seriously affected by the current accommodation and which would be improved by a move to appropriate accommodation.

Band 3 – priority – which includes those who need to move due to overcrowding or a moderate medical condition. A moderate medical condition is defined as one which is adversely affected by the current accommodation to a more than minor degree.

Band 4 – reduced priority – sheltered housing applicants; homeless households not owed a housing duty; applicants for shared or low cost home ownership and other applicants who are entitled to a reasonable preference but do not meet the residence requirements.

12. The scheme does not give cumulative priority to an applicant who meets the criteria for more than one priority band. In these circumstances the applicant is placed in the highest priority band for which they qualify.
13. The policy explains how requests for medical priority are assessed. Medical priority is not awarded because someone has a serious medical condition or disability. The current accommodation must adversely affect the person’s medical condition or disability or it must not meet essential needs arising from their medical condition or disability.
14. Applicants who apply for priority on medical grounds must complete an online assessment form. They must also provide any supporting evidence they want the Council to consider. The policy says:

“The onus is on the applicant to provide the information we need to complete the assessment; the Council will not routinely make its own enquiries, other than to seek advice from the Council’s Housing Medical Advisor (CHMA). Information provided by the CHMA is advice only and the decision whether to award priority or not will be taken by a relevant officer within the Housing Service. Where insufficient information has been provided to complete an assessment, the Council will advise the applicant of the further information required.”

15. The policy says the Council will notify the applicant of its decision on medical priority within eight weeks. The applicant may request a review of the decision.

Miss X’s housing needs

16. Miss X is a Council tenant. She lives with her son in a one bedroom flat with an open plan kitchen/living room. Miss X and her son share a bed.
17. Miss X has been on the Council’s Housing Register since January 2018. The Council awarded Band 3 priority for overcrowding because she needs a two bedroom property.
18. Miss X has a severe and enduring mental health condition for which she is prescribed medication. She is also under the care of the local mental health team. Her son has ADHD. He has challenging behaviour, disturbed sleeping patterns and wets the bed at night. He has an Education, Health and Care Plan for special educational needs and attends a special school.
19. Miss X completed a new online housing form in early June 2021. She said her current flat was unsuitable due to her mental health condition and her son’s ADHD.
20. In early July Miss X’s mother sent a senior manager in the Housing Needs service a letter from Miss X’s keyworker who is an Occupational Therapist in the mental health team. He forwarded it to the Housing Register assessment team. The keyworker said living in the flat brought back memories of abuse Miss X had suffered there in the past. This had a negative impact on her mood and reduced her motivation to meet her personal care needs. She also said a recent mental health review had noted an increase in the risk of self-harm and suicidal ideation. She strongly supported a move for Miss X which she said would have a positive impact on her mental health and wellbeing.
21. This letter was new evidence. The previous medical assessment in October 2020 had considered medical evidence about Miss X and Y. This included medical questionnaires and evidence from Miss X’s GP about her mental health condition and medication. But the July 2021 letter from Miss X’s keyworker contained new and updated information about an increased risk of self-harm and linked this directly to Miss X’s experience of being abused in her current home.
22. An assessment officer in the Housing Solutions decided on 1 September 2021 that Miss X did not meet the criteria for medical priority. She decided not to get an opinion from the Council’s medical adviser before making this decision. She wrote to Miss X giving the following reason for the decision:

“medical priority was not awarded because it is not housing related”.

23. In response to my enquiries the Council said the assessment officer did take account of the new evidence Miss X provided. She decided to rely on advice given by the Council’s medical adviser in a previous assessment in October 2020. She took the view that although there was a further medical letter, it did not provide any new information which warranted a new referral to the medical adviser.

24. The Council said officers are told to give brief reasons to explain why medical priority has not been awarded. In this case, the decision letter should have provided a short summary of why medical priority was not awarded. It has reminded officers to include a summary explanation in letters sent to applicants. However, it made the point that Miss X went on to request a review and the review decision letter gave more detailed reasons.

25. Miss X’s mother wrote on her behalf to request a review of the decision not to award medical priority later in September.

26. In mid-October 2021 Miss X forwarded a letter to the reviews team from her son’s consultant community paediatrician. The letter was brief and supported the family’s need to move to larger accommodation.
27. In late January 2022 the reviewing officer made a decision. She did not request advice from the Council’s medical adviser. She said she had considered both medical letters. She noted that the community paediatrician’s letter supported the family’s need for a larger property. However she made the point that the Council had already recognised that need by awarding Band 3 overcrowding priority. She did not set out any similar analysis of the keyworker’s letter about the increased risk of harm to Miss X. She said the threshold for awarding Band 2 medical priority was very high and she did not consider Miss X and her son’s medical conditions were affected to a sufficiently severe degree to justify this priority.
28. The review decision letter wrongly said Miss X had previously been awarded Band 3 medical priority. In fact, Miss X had Band 3 priority for overcrowding.

Error in changing her priority band

29. Miss X said she suffered a panic attack when she noticed in September 2021 that the Council had changed her priority from Band 3 to Band 4. She says the Council has not apologised to her for this error.
30. The Council accepts this was a mistake and says it was corrected within eleven days of Miss X notifying them. When it replied to my enquiries, the Council apologised for this error. It says it made no difference to whether Miss X was shortlisted for properties on Choice Homes in the eleven days she was moved to the lower band.

Restriction on bidding for houses

31. Miss X says whenever she tries to bid for two bedroom houses advertised on the Choice Homes website, it says she is not eligible to do so. She says she is therefore restricted to bidding for flats.
32. The Council says there is no restriction on Miss X bidding for two bedroom houses. But some properties advertised on Choice Homes may be reserved for homeless households. Others may be for applicants aged over 55 or for those who have assessed mobility needs. These properties are designated by symbols in the adverts. Miss X would not meet the eligibility criteria to bid for these properties.

My analysis

Assessment of medical priority

33. I do not share the Council’s view that the July 2021 letter from Miss X’s keyworker contained no significant new evidence. It said the recent mental health review had identified an increased risk of self-harm and suicidal thoughts. It made a direct connection between Miss X’s mental health and her background of being abused in the flat. I regard that as significant new evidence. I also note that these specific new concerns were not considered in the October 2020 medical assessment.
34. I have seen no evidence that the July 2021 letter was given sufficient consideration at either the initial decision or the review stage. The original decision letter did not mention the keyworker’s letter. Nor did it explain the reasons for the decision not to award medical priority. I accept the Council’s point that initial decision letters on requests for medical priority will briefly summarise the reasons. However in this case the letter did not give any intelligible reason. That was fault.
35. If the evidence had showed the keyworker’s letter was properly considered at the review stage, that would have corrected this fault. The reviewing officer’s letter says she had considered the keyworker’s letter. But the letter does not set out her analysis of the significant points made in that letter. I would contrast that with the reviewing officer’s reasoned analysis of the paediatrician’s letter about Y.
36. For these reasons, I intend to find that the Council did not give proper consideration to the keyworker’s letter which clearly stated there was an increased risk of harm to Miss X if she remained in the flat. A more recent medical assessment in March 2022 did not rectify this because it considered a different letter from Miss X’s GP. So I am likely to find this fault caused injustice to Miss X. She cannot be satisfied that the Council reached its decision not to award medical priority fairly after giving proper consideration to all the medical evidence submitted in 2021.
37. I would just add that the Ombudsman cannot decide whether Miss X meets the criteria for Band 2 medical priority. That is a decision the Council must make following a fair and thorough assessment of all the evidence Miss X submitted.

Error in changing priority from Band 3 to Band 4

38. The Council accepts it made an error and quickly put this right when Miss X reported it. I know this caused Miss X some anxiety at the time. However this was resolved within eleven days and it had no impact on the outcome of Miss X’s bids. For this reason, I consider the Council’s apology is a satisfactory remedy.

Restrictions on bidding for houses

39. The Council has confirmed Miss X can bid for two bedroom houses. But some properties advertised on Choice Homes will be reserved for applicants over the age of 55 or with assessed mobility needs. Miss X can only bid for properties with the symbol PH (priority homeseekers) and not those advertised for other tenants or homeless households. As a result, Miss X will not be eligible to bid for every two bedroom house advertised on the website.
40. I have seen no evidence so far that Miss X was unfairly restricted to bidding only for flats. And there is nothing in the Council’s housing allocations policy which would allow the Council to impose this restriction.

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Agreed action

41. Within four weeks of my final decision the Council has agreed to:
• Apologise to Miss X for not giving proper consideration to the July 2021 NHS keyworker’s letter;
• Arrange for a different senior officer to carry out a new review. The officer should consider the July 2021 letter and give Miss X the opportunity to submit any new evidence she has in support of the review. The Council should also reconsider whether it would be appropriate to refer the case to its medical advisers before making a new decision.
• Send Miss X a letter giving clear and detailed reasons for the review decision and provide us with a copy.

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Final decision

42. I have found fault in the way the Council considered whether to award medical priority and carried out its review of that decision. That fault caused injustice to Miss X and the Council has agreed to provide a suitable remedy.

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Investigator's decision on behalf of the Ombudsman