Conclusions
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I have seen no evidence that the PCT has yet offered a formal apology to Mrs S or Miss S for failing to consider funding Miss S’s treatment in the short term.
Maladministration and service failure
To sum up, we have found maladministration or service failure in the following respects:
- HCW adopted an excessively inflexible approach to the request to fund Miss S’s inpatient care. In particular, HCW:
- failed to take into consideration all relevant factors (including that Miss S was not at home when she became ill and her only sources of social support were outside Wales);
- failed to take into consideration the valid opinion of the English Consultant when it was reasonable to do so;
- insisted that a detailed discharge or follow-up plan was in place when it was not reasonable to do so; and
- failed to communicate adequately its conditions for funding.
- 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.
Injustice and hardship
Taken in the round, we have concluded that the maladministration and service failure identified above caused Miss S and her mother injustice and hardship: they were clearly caused significant distress by the failure to resolve the funding issues appropriately and expeditiously as Miss S’s condition deteriorated rapidly, and they each spent considerable sums of money paying privately for treatment which the NHS should have funded.
