The Public Services Ombudsman for Wales launched an investigation after receiving three complaints from representatives of care-users who had been left waiting more than three years for an outcome to their continuing healthcare claim. This is a package of care arranged and funded solely by the NHS for individuals outside of hospital who have ongoing health care needs.
The three complainants had their claims transferred to Powys Teaching Health Board, after the Welsh Government set up a system whereby retrospective claims submitted to individual health boards between August 2010 and April 2014 (known as “Phase 2 cases”) were mostly transferred to the Health Board. In June 2014 the Welsh Government issued guidance indicating that such claims should take no longer than two years to process.
All three complainants have been waiting in excess of three years to find out if their claims are successful, and the Ombudsman has received no indication of when the claims are likely to be concluded.
During the investigation, the Health Board said there were still some 330 claims to be reviewed.
Commenting on the report, Public Services Ombudsman for Wales, Nick Bennett, said:
“Frustratingly, this is a case of justice delayed, justice denied. While I am mindful of the fact that the Health Board is currently dealing with a large number of claims, and has experienced difficulties in recruitment, clearly Welsh Government guidance has not been complied with and the complainants have been left with a great deal of uncertainty during this period.
“I am concerned that there are other prospective claimants who face the same predicament as the three complainants, and so I have recommended that these people are entitled to the same redress if their claims have not been dealt with in the appropriate period.”
The Ombudsman recommended that the Health Board apologise to the complainants and make a payment of £125 to each in recognition of the considerable delay they had experienced.