Summary: Miss X complained the Council’s decision not to give her housing application medical priority is wrong. We have found evidence of fault in how it considered her request. The Council agreed to apologise and to backdate its decision to place her housing application into priority band B.

The complaint

1. The complainant, who I shall call Miss X, complained the Council failed to properly consider medical evidence presented in support of her request for an award of medical priority for her housing application. She says this means her family are living in unsuitable accommodation which is negatively impacting their physical and mental health.

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The Ombudsman’s role and powers

2. 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)
3. 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

4. I discussed the complaint with Miss X and considered information provided.
5. I considered the Council’s response to Miss X’s complaint and its housing allocations policy.
6. I set out my initial view on the complaint in a draft decision statement and invited comments from Miss X and the Council.

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What I found

7. The Council uses a banding system to identify those in the greatest housing need. Once an application has been approved, it will decide in which band to place the application based on the information provided on the application form and any further enquiries it has made in connection with the application. If an applicant’s circumstances change, their application may be moved to a different band.
8. Applicants can be assessed by the Council’s medical advisor and then placed in one of the following relevant bands:-

What happened

9. Miss X completed a medical information form in support of her housing application in September 2021.
10. In the medical information form Miss X explained:

• She lives with her partner and one year old daughter in a one-bedroom flat and she is pregnant with her second child.
• She had a car accident in 2012 and she has severe headaches. Her home is unsuitable because she does not have own space when she has a headache.
• She as a diagnoses of Post-Traumatic Stress Disorder (PTSD), severe anxiety and Unstable Personality Disorder. She is not taking any medication because she is pregnant.
• Her accommodation is affecting her mental health as she does not have her own bedroom to use when she is feeling unwell.
• Mould and damp in her home affect her breathing
• She would like to live in a house with a garden to relax in.

11. The Council’s medical adviser considered Miss X’s request for medical priority. The medical adviser said:

• Overcrowding is not a medical matter.
• Miss X’s mental health is not severe or unstable enough to warrant urgent or enhanced psychiatric care.
• Miss X does not receive any care services.
• A garden is not medically essential.

For these reasons the medical adviser said there was no compelling medical evidence that her home was unacceptable for health reasons.

12. On 4 January 2022 the Council wrote to Miss X explaining that it had considered the response from its medical adviser, and it was not awarding her housing application any medical priority. It said her application would remain in Band D, and she was eligible to bid for a two-bedroom property. The letter advised Miss X that she could appeal against the decision.
13. On 10 January 2022 Miss X provided further medical evidence to the Council, including reports detailing her injuries from the car accident in 2012 and details of her mental health. She also explained her partner has osteoarthritis and nerve and disc problems in his lower back which are worsening because of poor sleeping arrangements in their overcrowded home. Miss X also told the Council she had given birth to her second child.
14. On 16 February 2022 Miss X provided more medical information and told the Council she would provide further evidence about her partner’s health.
15. On 5 January 2023 Miss X asked the Council to review its January 2022 decision not to award her medical priority. In support of her review request, she provided copies of her medical records and details of medication taken by her children.
16. Miss X also provided a letter from her doctor. It said her home is negatively impacting her health. It also said she is pregnant with her third child and unable to get sufficient sleep because of a lack of space in her home. Her partner also provided a statement explaining how their home is impacting their health.
17. On 8 March 2023 the Council wrote to Miss X in response to her request. It said it there was no new evidence based on health conditions and so it could not further assess her medical priority. It said the evidence Miss X provided was based on overcrowding. It said the council’s housing service had visited their home about mould, and her children’s health conditions related to damp and mould. It said her housing application would remain in priority Band C.
18. In May 2023 Miss X requested a review of the Council ‘s decision.
19. On 31 May the Council wrote to Miss X explaining that its medical adviser has considered her request for medical priority. The adviser said:

• Overcrowding attracts its own priority.
• Miss X’s mental health issue is not severe or unstable enough to warrant urgent enhanced psychiatric care.
• Miss X is not receiving any care services normally associated with someone who has a severe inability to function on a daily basis.

For these reasons the medical adviser said there were no compelling grounds making Miss X’s current home unsuitable on medical grounds.

20. The Council said that considering its medical adviser’s view and information she had provided ncluding a letter from her doctor and details of her mental health it considered her home is meeting her needs and therefore it would not award her any medical priority. It said Miss X’s application was in Band C with a high priority and she is eligible to bid for three-bedroom accommodation.
21. Following its decision, the Council told Miss X’s Recovery Worker (who was helping her with her review request) that it was looking to nominate her for a new build property with a housing association, when construction is complete.
22. In June 2023 the Council told Miss X that following a review of the medical information provided, it was placing her housing application into priority band B. This was because it considered her partner’s health conditions were being significantly impacted by their current accommodation.

Analysis

23. The Ombudsman is not an appeal body. Our role is to review how decisions are made.
24. The Council’s review decision of 4 January 2023 says it could not further assess its decision of 4 January 2022 because no new medical information was provided by Miss X. This is incorrect. Miss X gave new medical evidence to the Council on 10 January 2022 and 16 February 2022. She also gave the Council new medical evidence with her review request in January 2023. This included a letter from her doctor explaining her home was negatively impacting her health and a statement from her partner explaining the impact of their living conditions on their health.
25. The Council’s decision in January 2022, and its reviews in January 2023 and May 2023 appear to have dismissed Miss X’s overcrowding related medical problems. Its January 2022 decision said that overcrowding is not a medical matter. The review request replies say that overcrowding attracts its own priority. I recognise that overcrowding itself is not a medical matter. However, if overcrowding is aggravating medical problems, as set out in evidence provided by Miss X, the Council should consider if the overcrowding merits medical priority as well.
26. Additionally, I note the Council’s Allocations Policy says an applicant can have both a need to move because of overcrowding and because of medical priority. It says that an applicant with a combination of non-medical priority, such as overcrowding, and medical priority could result in an applicant moving from Band D to Band C or Band C to Band B.
27. The Council’s review decision says that it understands its housing service visited Miss X’s home about her reports of mould and damp. Its response does not say the visit resolved the problem. Therefore, I am not satisfied the Council has properly considered the impact of damp and mould on the health of Miss X’s family and whether an award of medical priority on these grounds was warranted.
28. Because of the reasons discussed above I am not satisfied the Council has properly considered Miss X’s requests for medical priority up to this point.
29. However, after issuing my draft decision the Council confirmed that it has considered evidence provided by Miss X again and as a result her application is now in priority band B. I am satisfied the new revised decision means my concerns that Miss X’s housing application was not awarded the correct priority banding have been resolved.

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Agreed action

30. To remedy the injustice caused by the fault I have identified, the Council agreed to take the following action within 4 weeks of my final decision:

• Apologise to Miss X for the identified fault and;
• Backdate the award of priority band B to 13 January 2023 when Miss X first sent the Council the information that has resulted in the higher priority banding being awarded.

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Final decision

31. I have ended my investigation as the Council has agreed to my recommendations which address the injustice caused by the fault I found.

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Investigator's decision on behalf of the Ombudsman