Council and ICB failed to manage funding dispute adequately, causing “avoidable delay” in hospital discharge: Ombudsman

The man behind the complaint, Mr X, complained about “repeated failures” of the council and ICB to work together. He complained this caused a prolonged delay in discharging his wife (Mrs X) from hospital, and left her without funding for necessary night-time care.

The Ombudsman investigated and found fault with the council and the ICB.

The report noted: “There is evidence of a significant amount of contact between the council and the ICB during November 2023, with both organisations aware of the need to resolve the dispute and find a way forward. Nevertheless, it took 24 days to reach an agreement to use the Discharge to Assess process and for the ICB to fund the night-time element of Mrs X’s care. This was too long and is fault.”

In communication with the Ombudsman, the council acknowledged that “frequent escalation could have benefited from a formalised approach to reach earlier resolution”.

The Ombudsman continued: “Overall, there was a period of just over three weeks when Mrs X’s discharge from hospital did not progress because of fault. This related to a funding dispute where there was no prior agreement about interim funding during disputes, and no formal escalation points. Because of this fault Mrs X remained an inpatient for longer than necessary.

“This was a busy environment where she appears to have been cared for in bed for significant periods. Mr X explained this was mentally and physically hard for Mrs X, and for him in having to witness it. I cannot say that this three-week delay is likely, on its own, to have caused an avoidable deterioration in Mrs X’s health. However, the discomfort of being in hospital and the stress of the situation were injustices to Mrs X and to Mr X.”

The Ombudsman however did not find fault in the way each organisation considered Mrs X’s night‑time needs against relevant eligibility criteria.

To remedy the injustice caused, the Ombudsman recommended the council and ICB:

• both write to Mr X to acknowledge the faults identified and to apologise for the impact of these failings;
• each pay £250 to Mr X;
• complete an action plan for finalising and implementing a dispute process. The action plan should include timeframes for key actions, escalation plans and information about appropriate senior oversight.

Hampshire County Council and NHS Hampshire and Isle of Wight Integrated Care Board have been approached for comment.

Lottie Winson