Failure to follow local procedures when handling a funding request

What happened

Ms B's GP applied to the local CCG for funding for an operation she needed because she did not meet the usual criteria for NHS funding. The CCG considered Ms B's case at a panel and decided that there was no exceptional reason to grant funding.

Ms B later complained to us about the procedure the CCG used. She noted that the CCG had not followed its published procedures and she felt the panel was not independent. Ms B also complained about the CCG's handling of her complaint.

What we found

The CCG did not follow its local published procedures because it did not invite Ms B to make a personal statement or attend the panel. The CCG's complaint response was inadequate as it did not acknowledge the failure to follow due process and did not provide an appropriate remedy for this.

We did not uphold the complaint about the independence of the CCG's panel, or the further complaint about a decision to close Ms B's complaint when her consent had not been received within a specified time.

Putting it right

The CCG apologised to Ms B. It also reviewed the patient information leaflet to make sure it fully reflects the CCG's procedure for handling funding requests.