Report by the Public Services Ombudsman for Wales and the Health Service Ombudsman for England of an Investigation of a complaint about the Welsh Assembly Government (Health Commission Wales), Cardiff and Vale NHS Trust and Plymouth Teaching Primary Care Trust: 3rd report, session 2008-2009

Front Cover
This report is a joint one as Mrs S's complaint concerns events that span the jurisdictions of the Public Services Ombudsman for Wales and the Health Service Ombudsman for England. Mrs S's adult daughter, Miss S, lived in south Wales. However, while staying in the south west of England, she became depressed and developed anorexia nervosa. She came under the care of Plymouth Teaching Primary Care Trust (the PCT), initially as an out-patient and then, from October 2006, as an in patient. In October 2006 the PCT approached a consultant psychiatrist in Miss S's home area (the Welsh Consultant) employed by Cardiff and Vale NHS Trust (the Trust) to ask him to take over her care. He declined. Miss S's condition deteriorated further and she was referred to the local specialist NHS eating disorders unit (the EDU). The referral was accepted, subject to funding, and an application was made to Health Commission Wales (HCW) for this. HCW refused to fund the admission, principally on the grounds that Miss S had never been assessed by the services in Wales, and because no follow-up plan had been put in place for when she was discharged. Mrs S then elected to have Miss S admitted to a private eating disorders centre, where they both funded Miss S's care, use their life savings to pay. Mrs S complained to us on behalf of Miss S that the NHS should have funded Miss S's care and that the family had been forced to take action as Miss S's condition was serious and deteriorating, and because it appeared that the question of which NHS body was responsible for funding was unlikely to be resolved quickly. The Ombudsmen found maladministration or service failure in several respects of including that HCW adopted an excessively inflexible approach to the request to fund Miss S's in-patient care. In particular, HCW failed to take into consideration all relevant factors and failed to take into consideration the valid opinion of an English Consultant when it was reasonable to do so. The Trust unreasonably refused the request to take over Miss S's care in October 2006; The PCT failed to provide short-term funding for Miss S's treatment and thereby placed her at clinical risk. HCW, the Trust, the PCT and the Welsh Assembly Government have agreed to accept the Ombudsmen's recommendations.

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