2. Mr O complains the ICB have failed to provide adapted cognitive behavioural therapy (CBT is a talking therapy commonly used to treat anxiety and depression) as recommended by his psychiatrist.
3. Mr O says waiting for adapted CBT has had an impact on his mental health and his education.
4. He would like to receive the CBT treatment. He would also like the ICB to make service improvements.
5. Mr O is autistic and has attention deficit hyperactivity disorder (ADHD), depression and anxiety. He had a private psychiatry assessment in October 2022 and the psychiatrist recommended a referral for adapted CBT. The CBT methods are adapted to be more effective for autistic people. At the end of 2022, the psychiatrist sent the referral for adapted CBT to the ICB to consider funding.
6. In February 2023, the ICB wrote to Mr O explaining there would be a delay in sending a response due to exceptional demand on the adapted CBT service. In April Mr O sent an email but did not get a response. In May he contacted the ICB again through its website and did not get a response.
7. On 4 June, he submitted a complaint by email. He chased the ICB four more times. On 25 September the ICB replied. It apologised for the unacceptably long time it took to reply and said there had been an administration error.
8. It explained that the local provider (of adapted CBT) had put all referrals on hold since November 2022 due to the volume of outstanding referrals. The ICB explained it was attempting to find new providers, but there was no update for when the service would be available. The ICB explained it would be holding regular meetings to consider what appropriate solutions could be offered to patients on the waiting list.
9. On 18 December the ICB wrote to Mr O and advised it was working to get more services and it expected the services to be available from April 2024.
11. We contacted the ICB for more information about the process and its plans. It explained there are no policies in place to address the exceptional demand on this service. It noted this is a recent unusual situation both locally and nationally and all providers of the service are at full capacity. It explained it is working with NHS England to explore solutions to the capacity issue.
12. The ICB confirmed it is developing an arrangement with four providers to provide capacity for conditions that are not currently provided through locally commissioned services.
13. We queried the expected waiting time for Mr O. The ICB stated there are 30 cases with funding agreed who are waiting for services. The ICB said the referrals would be seen in order they were received.
14. We asked the ICB about any service improvements that have been made because of this situation. It explained the entire care pathway for neurodevelopmental conditions is subject to review, redesign and re-procurement and is being reviewed at executive level. This has included a review of the referral pathway for specially adapted interventions, with the aim of building in more capacity to meet the demand.
15. Because this is an exceptional situation, there are no standards to measure the ICB’s response against. There are no published timescales of how quickly adapted CBT should be provided. We are unable to say whether there have been failings or not.
16. Mr O’s ideal outcome is to get the adapted CBT. We cannot achieve this by an investigation. The ICB has said he should be receiving this soon.
17. We are unable to influence the waiting list. It is clear from our communication with the ICB that it is taking steps to make sure services are allocated once the appropriate provider has been selected. This is reassuring.
18. Our guidance says: ‘There will be occasions when we decide that there are other reasons why we should not investigate a complaint made to us. These include: • If the outcome sought is not achievable • That an investigation would not be practical, would not reach a satisfactory conclusion and there would be no value in providing that response through an investigation.’
19. We will be unable to make a difference to when Mr O is given the adapted CBT.
20. We thank Mr O for bringing his complaint to us and we are sorry that we cannot look into this further. We appreciate the difficulties he has faced in trying to get his adapted CBT and hope he is reassured by the ICB’s efforts to provide services as soon as possible. We hope he can access adapted CBT soon and that this helps him with the problems he is facing.
1. We have carefully considered Mr O’s complaint about Kent and Medway Integrated Care Board (the ICB). We are grateful to Mr O for taking the time to share his concerns with us. We got information from the ICB about the steps it is taking to commission the service Mr O needs. We do not think we could achieve anything more and have decided not to look at his complaint any further.