Report Date


Case Against

Betsi Cadwaladr University Health Board



Case Reference Number



Upheld in whole or in part

Ms C complained about treatment provided by the Health Board. We investigated whether the decision, following an appointment in May 2021 with a consultant psychiatrist, that she was not entitled to treatment to address her binge eating (BED), was made appropriately and in line with relevant guidance. We considered whether, given the information available to the treating consultant psychiatrist by the August 2021 consultation with Ms C, she was then given sufficient treatment, including whether she should have been offered EMDR treatment from this date. Finally we investigated the Health Board’s handling of Ms C’s complaint, specifically that a complaint response of 5 October 2021 listed the report author as the person Ms C had made a complaint about, and that there were inaccuracies in some of the Health Board’s responses.

We found that the Health Board did not offer appropriate support for people with BED, which contradicted relevant national guidance. While a lack of provision for eating disorders is a wider issue nationally, this was still an injustice to those within the area who needed this support, and particularly to Ms C, who was initially advised there could be a service to support her. We found that the Health Board had been provided with sufficient evidence that Ms C had been diagnosed with PTSD by the August consultation, and therefore efforts should have been made to source suitable treatment (which could have included EMDR or an appropriate alternative) from this date. We also found significant issues with the way Ms C’s several complaints were handled, as some of the findings appeared to have been based on incorrect information, and the complaint investigations were not always carried out in line with relevant guidance, which specifies that a staff member should not be involved in a complaint that relates to them. We therefore upheld these complaints.

We recommended that the Health Board should apologise to Ms C for the issues we identified and offer her a payment of £458, in recognition of the multiple complaint handling issues identified and as partial refund for the EMDR treatment she had funded privately. We also recommended that the Health Board should remind all relevant clinical staff of what its eating disorders service can/cannot assist with, and should highlight this report to complaints handling staff, remind them of the relevant requirements within PTR in relation to who should investigate a complaint, and the requirement to undertake a thorough investigation. Finally we recommended that the Health Board should actively explore options for the provision of BED treatment as recommended by nationally recognised guidance, including private or out of area options if necessary, and feedback its findings to the Ombudsman.