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Bury CCG

P-001120 · Statement · Decision date: 16 September 2021 · View NHS Greater Manchester ICB scorecard
Complaint (AI summary)
Mrs E complained that Bury CCG refused granted therapy sessions, denied mental health service access, and poorly handled her complaint, severely affecting her mental health.
Outcome (AI summary)
The ombudsman found no failings in the CCG's complaint handling. The CCG is not responsible for the therapy service, and these concerns were previously considered regarding another Trust.

Full decision details

The Complaint

3. Mrs E complains about the service she received from the CCG in November 2020. She claims she was granted thirty-six sessions of therapy and the CCG refused to provide them and denied her access to mental health services. Mrs E also complains about how the CCG dealt with her complaint.

4. Mrs E says this resulted in her mental health being severely affected. She says she has exhausted all avenues to try and resolve her complaint and no one will ‘take responsibility’. Further, she says she feels ‘ignored’ and ‘let down’ by mental health services and has no support. Finally, Mrs E says she feels as though Bury CCG have ‘thrown her away like a bag of rubbish’.

5. Mrs E would like an apology and access to the therapy sessions she has been granted.

Findings

Bury CCG refused to provide therapy sessions and denied her access to mental health services in her area.

8. Mrs E complains following a judicial review against the Trust, the CCG failed to provide her with therapy sessions and denied her access to mental health services.

9. It is important to explain the role of a CCG.

10. CCGs were established as part of the Health and Social Care Act 2012. CCGs are groups of general practices which come together in each area to commission the best services for their patients and population.

11. CCGs then buy services for their local community from any service provider that meets NHS standards and costs – these could be NHS hospitals, social enterprises, voluntary organisations or private sector providers. CCGs commission a wide range of services including mental health services, urgent and emergency care, elective hospital services and community care. CCGs commission most of the hospital and community NHS services in the local areas for which they are responsible. They are not responsible for administering care or treatment to an individual.

12. A CCG has a responsibility to commission appropriate healthcare to meet the clinical needs of individual patients within its area of responsibility.

13. We can see Bury CCG provided funding to allow Mrs E access to mental health services both within and out of her area. Mrs E has not complained to us with to a regard to funding or the way the CCG commissions services but concerns about the services themselves.

14. With regards to providing therapy sessions and access to mental health services, this responsibility lies with the Trust.

15. We can see Mrs E raised these concerns with the Trust in 2019 and we have already considered this part of her complaint.

16. As we have already looked at this part of Mrs E’s complaint and reached a decision, we will not be taking any further action.

The CCG’s handling of Mrs E’s complaint

17. Mrs E says when she addressed her concerns with the CCG, it refused to deal with her complaint and referred her back to letters sent by the Trust.

18. We note, this would be the appropriate route as the Trust is the organisation responsible for delivering care and treatment about Mrs E’s mental health.

19. The CCG’s Complaints Policy states:

‘Complaints about medical practices, dental practices, opticians and pharmacists should be directed to the practice manager or business manager in the first instance. Complaints about other healthcare organisations should be directed to the appropriate complaints department at the relevant organisation.’

20. As per its policy, we can see the CCG was correct to refer Mrs E to the Trust. Further, the Local Authority Social Services and National Health Service Complaints (England) Regulations 2009 states if an individual has already made a complaint to the provider (in this case the Trust) and are unhappy with the outcome, they are unable to raise the same issue with the CCG. If they remain unhappy, they must go directly to the Ombudsman with their concerns.

21. As above, Mrs E approached our office with her concerns in 2019. It appears she has now raised the same concern with the CCG.

22. Taking this into account, we can find no evidence of failings in terms of the way the CCG handled her complaint as it signposted her to the correct organisation.

23. We appreciate Mrs E’s strength of feeling about her complaint and it is clear she feels deeply concerned about the service she received. We do not wish to diminish the impact she says these events have had for her. We hope we have explained the thorough consideration we have given to our decision and clearly outlined the reason for it.

Our Decision

1. We have carefully considered Mrs E’s complaint about Bury Clinical Commissioning Group (the CCG). Her complaint is that the CCG did not provide mental health services and about the way it handled her complaint.

2. We were sorry to hear about Mrs E’s concerns and the distress she has experienced. We reviewed information provided by Mrs E and information from the CCG. We have not seen any indications of failings in the way the CCG handled Mrs E’s complaint. Also, the CCG is not responsible for providing the service Mrs W complains about. This responsibility lies with Pennine Care NHS Foundation Trust (the Trust). We can see Mrs E raised these concerns with the Trust in 2019 and we have already considered this part of her complaint. Therefore, we will not be taking further action in relation to this complaint.