The Ombudsman's final decision
Summary: Miss X complained that she has been unable to access a neurodevelopmental assessment for her child. Miss X said it has had an impact on her child’s education, and caused her stress and upset. We do not find the Council at fault.
The complaint
The complainant, who I refer to here as Miss X, complained that she has been unable to access a neurodevelopmental assessment for her child.
Miss X said it has had an impact on her child and the child’s education because the Council was not able to understand her child’s needs without an assessment. Miss X said it caused her stress and upset.
The Ombudsman’s role and powers
We investigate complaints of injustice caused by ‘maladministration’ and ‘service failure’. I have used the word fault to refer to these. We consider whether there was fault in the way an organisation made its decision. If there was no fault in the decision making, we cannot question the outcome. (Local Government Act 1974, section 34(3), as amended) If we are satisfied with an organisation’s actions or proposed actions, we can complete our investigation and issue a decision statement. (Local Government Act 1974, section 30(1B) and 34H(i), as amended) The Local Government Act 1974 sets out our powers but also imposes restrictions on what we can investigate.
We cannot investigate most complaints about what happens in schools. (Local Government Act 1974, Schedule 5, paragraph 5(2), as amended) We investigate complaints about councils and certain other bodies. We cannot investigate the actions of bodies such as the Children and Adolescent Mental Health Service (CAMHS). (Local Government Act 1974, sections 25 and 34A, as amended)
How I considered this complaint
I considered the information and documents provided by Miss X and the Council. I spoke to Miss X about her complaint. Miss X and the Council had an opportunity to comment on an earlier draft of this statement. I considered all comments received before I reached a final decision.
I considered the relevant procedure, set out below.
What I found
What should have happened Recently, the Council implemented a Neurodevelopmental Assessment Pathway (NAP). This aims to assess the needs of children and young people showing persistent and complex presentations due to a potential underlying neurodevelopmental need. The Council set out the NAP’s procedure on its website.
The procedure said the NAP accepted requests from schools, parents, and carers. The request is then considered by the triage team. The triage team will decide how the referral is dealt with. This could be: acceptance onto the NAP; or that the triage team need more information; or that the referral is sent back to the referrer, asking for information; or that the information does not indicate a need for a specific neurodevelopmental assessment at that time.
If a child is accepted onto the NAP, the child will be listed for an appointment with either the Children and Adolescent Mental Health Service (CAMHS) or the Community Paediatrician. Once it has been decided which team is best suited to the child’s needs, either CAMHS or the Community Paediatrician will send an appointment for the child once they reach the top of that service’s waiting list.
What happened Miss X has a child, C. C’s school referred C to the Neurodevelopmental Assessment Pathway (NAP) in January 2022.
Less than a week after the Council received this referral, Miss X complained that C was on a 12-month waiting list for a neurodevelopmental assessment. She said the timeframe was unacceptable.
The Council responded to Miss X’s complaint in February. It said there was no clearly identified single wait time, and this was because children will need to be seen by different services, depending on their needs.
The Council said that without knowing who told her there would be a 12-month wait, it was difficult to provide a clear explanation of what the person meant when they said this to her. The Council said there were long waits for neurodevelopmental assessments across the country due to staff shortages and COVID-19 pressures.
In March, the Council responded to Miss X’s complaint at stage two of its complaints procedure. It said it anticipated C’s referral would be triaged within the next month. It said waiting times can vary depending on which services are involved.
Miss X then complained to the Ombudsman.
In April, the Council triaged C’s referral and accepted C onto the NAP, to be seen by the Children and Adolescent Mental Health Service (CAMHS). CAMHS then contacted Miss X with an appointment for C.
Analysis Miss X complains that she has been unable to access a neurodevelopmental assessment for her child, C.
Miss X says the school told her it had made a Neurodevelopmental Assessment Pathway (NAP) referral for C in November 2021. She says when she contacted the Council about it, it said it had not received the school’s referral. Miss X says the school then made a second referral in January 2022.
The Council says it did not receive a referral for C in November 2021. As I have said above, I cannot investigate the school’s actions because that is not within our jurisdiction. For this reason, I cannot determine whether the school did nor did not make a referral for C before January 2022.
I find that the Council acted on the referral it received for C in January 2022. So, I do not find the Council at fault.
Miss X says it was the school that told her it would be a 12-month waiting list for the NAP, not the Council. She says the Council told it could not say how long the wait would be. She says that, because she did not know how long C would have to wait for a neurodevelopmental assessment, she decided to pay for a private assessment. This private assessment was arranged in March/April and took place in May/June. Miss X believes C would have got this through the NAP.
I do not find the Council at fault for the mixed messages Miss X received from the school. The Council told Miss X that it did not know how long the wait would be, and explained the reason for this in detail in its complaint responses. The Council is not responsible for what the school told Miss X.
Miss X complains that she has been unable to access a neurodevelopmental assessment for her C. I do not agree. The Council accepted the school’s referral and assessed it through its NAP triage team. The outcome was that CAMHS offered C an assessment. These actions and outcomes are in line with the NAP procedure, set out above.
Miss X did not want to wait for the neurodevelopmental assessment to be provided through the NAP, if this was to be the outcome. So, she paid for a private assessment. This was her choice. At the point Miss X chose not to wait, and to pay privately, the referral had only been with the Council for two to three months.
The Council is not responsible for waiting times of other services, in this case CAMHS. The process is that the referral is triaged to see which service is best placed to complete a neurodevelopmental assessment. After a referral has been triaged, the waiting times for an assessment are that service’s responsibility. As I have said above, I cannot investigate the actions of CAMHS because CAMHS is not within our jurisdiction.
Regarding the length of time between the Council receiving the referral and triaging it, I do not find the Council at fault. We would not expect the Council to have acted any quicker than it did, particularly for a new service which inevitably had some teething problems. The Council told Miss X in March that C’s referral would likely be triaged in April. I find that this happened.
I find the Council acted quickly to address its initial problems rolling out the NAP. I do not consider the Council’s actions in addressing these initial problems caused any delay in processing C’s referral.
For all of these reasons, I do not find the Council at fault.
I note that the NAP procedure has changed since the school made its referral. I have considered the procedure as it was when the school made its referral. This is what I have outlined above.
Final decision
I have completed my investigation and I do not uphold Miss X’s complaint. This is because there is no fault.
Investigator's decision on behalf of the Ombudsman