Mrs D's family complained about the decision not to award their mother continuing healthcare funding. They also said that there had been significant delays in the decision–making process.
What happened
In spring 2012 Mrs D's family appealed their local Primary Care Trust's (PCT) decision to refuse continuing healthcare funding for their mother. The PCT did not uphold the appeal, and sent Mrs D's family clarification of its decision in summer 2012. The family then asked NHS England to independently review the decision.
The review was initially delayed for one month because the PCT told NHS England that the local appeals process was not complete. There was then a nine–month delay before the PCT gave NHS England all the information it needed for the review.
NHS England upheld the PCT's decision that Mrs D was not eligible for continuing healthcare funding, and her family complained to us.
What we found
We partly upheld the complaint. There was no fault in NHS England's decision that Mrs D was not eligible for continuing healthcare funding. However, we were critical of NHS England for not acknowledging the unnecessary delays in the process. Although we did not consider that the delays had been caused by NHS England's actions, we concluded that it should have acknowledged the delays and remedied them in the independent review.
Putting it right
As a result of our findings, NHS England apologised to Mrs D's family and explained how it had improved its processes.
Midlands and East of England Commissioning Region
Cambridgeshire
Did not apologise properly or do enough to put things right
Did not take sufficient steps to improve service
Apology
Other