Background
CDE is a 15-year-old, non-verbal, severely sight-impaired, life-limited and medically fragile child with Lowe syndrome. For approximately nine years, specialist hospice Richard House provided short breaks and formed part of his crisis safety net. After the hospice closed in December 2025, NHS North East London Integrated Care Board and the London Borough of Tower Hamlets issued a joint response describing the health and social-care provision intended for him.
CDE challenged that response, alleging that the defendants had failed to secure a written, child-specific and operationally deliverable pathway covering respite, palliative and end-of-life care, urgent escalation and post-discharge support. Permission was refused on the papers. At the renewed hearing, the evidence showed continuing reassessments and discussions, an Advance Care Plan, and arrangements involving Haven House, Demelza and care at home. CDE had also experienced prolonged hospital admissions, while his family had received no respite since Richard House closed and had twice paid for private ambulance transfers.
The Court’s Holding
Deputy High Court Judge Nigel Cooper KC refused permission for judicial review because none of the proposed grounds was arguable with a realistic prospect of success. Neither the integrated care board nor the council was legally required to produce the detailed “operationally deliverable plan” sought by CDE or to designate a single operational lead coordinating every part of his care.
The evidence showed an assessed NHS care package that was being delivered or was available for delivery, a responsive social-care plan, palliative care and an Advance Care Plan. The arrangements involving Haven House, Demelza and home care met the provision for 18 social-care-funded nights and 20 health-funded nights, and the defendants were cooperating and reassessing the package when circumstances materially changed.
The family’s private ambulance costs, lack of respite following Richard House’s closure, and EDC’s surgical and mental-health needs did not establish an arguable breach of statutory duty. Nor did Articles 2 and 8 of the European Convention on Human Rights or the public sector equality duty supply a separate sustainable ground. The court revoked an earlier £5,000 costs order after the integrated care board withdrew its claim for those costs.
Key Takeaways
- Health and social-care authorities were not legally obliged to produce the particular comprehensive written operational plan requested by the claimant.
- The available hospice, home-care, palliative-care and respite arrangements were sufficient to defeat an arguable claim that the authorities had failed to meet their duties.
- Disruption and delay following a hospice closure do not by themselves establish unlawfulness where replacement provision is developed within a reasonable period and remains subject to reassessment.
Why It Matters
The decision distinguishes an authority’s duty to assess and arrange care meeting a disabled child’s reasonable needs from a claimed duty to document every component in a single, highly detailed operational pathway. At the permission stage, gaps in preferred documentation or coordination will not suffice where the evidence demonstrates that suitable provision is available and responsive to changing needs.
The judgment also illustrates that serious family hardship and imperfections in the transition between providers, while relevant, must be connected to an identifiable and arguable breach of public-law duty before a judicial review may proceed.