Mrs N was refused funding for a surgical procedure. She was advised, wrongly, that she would need a psychological assessment to get the funding.
What happened
Mrs N sought approval for a surgical procedure not normally funded by NHS Halton and St Helens (the PCT). The letter setting out the PCT's decision suggested that she seek treatment that had no bearing on her application. Mrs N complained about the failure to fund the surgery she required, which had forced her to seek the procedure privately. She also complained about the inaccurate information she received.
Halton Clinical Commissioning Group (CCG) has inherited the PCT's responsibility in this matter.
What we found
The PCT reached a reasonable decision that was in line with local policy and guidance when it decided not to fund Mrs N's surgery.
However, the letter the PCT sent Mrs N was confusing, contained factual errors and suggested unnecessary treatment that ran counter to the PCT's policy. The letter fell well below the standard we would expect from a public body.
As a result, Mrs N embarked on a futile and time-consuming course of action that ultimately caused her great distress.
Putting it right
The CCG paid Mrs N £250 in compensation for her distress.
Halton CCG
Halton
Not applicable
Compensation for non-financial loss