Permission to appeal application lodged with Supreme Court in dispute over health care plan for 12-year-old boy

In A, R (On the Application Of) v North Central London Integrated Care Board [2025] EWCA Civ 485, the Court of Appeal allowed a cross-appeal brought by the ICB and dismissed an appeal and notice to affirm brought on behalf of the child (A).

Lady Justice Whipple, with whom Lord Justice Males and Lady Justice King agreed, quashed a High Court judge’s mandatory order requiring the ICB to draw up a fresh health care plan.

A suffers from a genetic disorder which renders him severely disabled, requiring 24-hour care. The North Central London ICB is responsible for commissioning A's continuing care.

The ICB originally contracted with a third-party supplier, Enviva, for A's care. However, it became dissatisfied with Enviva's services and terminated Enviva's contract on 9 July 2024, engaging a new third-party supplier called Nursing Direct to provide care services to A.

A's parents were dissatisfied with Nursing Direct. They wanted Enviva to carry on providing care for A. They declined the services of Nursing Direct and continued to engage Enviva to look after A at their own cost.

A, who was represented for litigation purposes by his mother and litigation friend B, brought a judicial review against the respondent ICB, advancing three grounds of challenge:

1. The respondent was in breach of its obligation under s 42(3) of the Children and Families Act 2014 to ensure that there was a lawful health care plan in place in relation to him.
2. The respondent had acted “irrationally” in terminating Enviva's contract on 9 July 2024.
3. A's parents were entitled in restitution to repayment of the costs incurred by them after 10 July 2024.

By a judgment dated 23 October 2024, in the High Court MacDonald J granted permission for judicial review on the first ground, and found in A's favour on that ground.

He held that the respondent had “breached its statutory duty” by failing to arrange for an updated health care plan for A. By way of remedy for that breach of statutory duty, he made a mandatory order requiring the ICB to arrange a health care plan for A by 27 November 2024.

However, the judge dismissed grounds 2 and 3.

The appellant appealed the judge's conclusion on the third ground. In response to that appeal, the ICB cross-appealed the judge's finding on the first ground on the basis of fresh evidence which the ICB said would lead to a different outcome on ground 1.

The Court of Appeal agreed that the Respondent's cross-appeal should be allowed, and the mandatory order for a new health care plan should be quashed. The court dismissed A's appeal and Notice to Affirm.

An application to appeal this decision in the Supreme Court has now been lodged.

Lottie Winson